Bolivarian Republic of Venezuela

Ministry of popular power for education

National Experimental University of the Central Plains
“Romulo Gallegos”
National Training Program
Optometry-Optics

HISTORY OF PUBLIC
HEALTH IN
VENEZUELA

Student Teacher:
Joely Marcano Maria Aguiar
CI: 26,518,879
San Juan de los Morros, 2020
 History of Public Health in Venezuela.

Defining the term health is, in itself, a controversial issue; much more difficult is
specifying the guidelines and structures that must be incorporated and coordinated for
the development of a country's public health. The challenge becomes more complex
when the general context (political, economic, environmental, educational and social)
that defines a population in time and space is adverse. Such was the process of
Venezuela in the first third of the 20th century. Trying to make an approach to the study
of Venezuelan public health without taking into account the national situation prior to
the creation of the first government institution with specific health functions, would be,
in addition to being incorrect, unfair to the country's own historical evolution. Added to
this, international events, which drew and blurred the internal landscape through signed
agreements and commitments, where all types of interests came into play. Having
specified the basic scenario where the topic under study develops, all that remains is to
define the problems to be elucidated: How did the institutionalization of Venezuelan
public health develop during its first 16 years of existence? And what international
elements participated or influenced its development?

The first medicine in Venezuela was indigenous to the Piache, Chaima and
Tamanaca voice, with a plurality of functions: doctor, priest, fortune teller or sorcerer,
possessors of white or black magic powers. Its medical functions were reduced to
sucking, massages, blows and their application depending on the circumstances and
severity of the cases. These are accompanied by maracas, smoked tobacco or the
absorption through the nose of the powders of the niopa, anoto or achiote plant. The
salivas performed circumcision in children 8 days old and of both sexes. You bleed,
cutting the wounds and then cauterizing them with fire. Reduction of fractures or
composition of dislocations.

The main doctors arrived at the beginning of the 16th century, as an integral
part of military expeditions. This was the case of Maestre Bernal, Italian apothecary,
and surgeon Coleccion Razetti. . 362 Díaz Bruzual A, López Loyo E. Spaniard named
Alonso, the latter showed off surgical skills in the first bloody encounter with the
indigenous people of Chichiriviche. On Ojeda's second trip, the name of the apothecary
Diego Montes de Oca appears. Vicente Yañez Pinzón is accompanied by the doctor and
notable geographer Garci-Fernández. In 1530, along with the expedition of Juan
Alemán (Juan Seissenhoffer), the physicist Hernán Pérez de la Muela, adventurer and
skilled surgeon, arrived. He treated Alfinger when he arrived sick in Coro and
recommended that he travel to Santo Domingo for his final recovery. This Pérez de la
Muela becomes the first doctor to settle in Venezuela, the others did not stay. At the end
of 1569, Mr. Luis de Rojas, a doctor, and Juan Díaz de la Puerta, a senior surgeon,
arrived in Cumaná.

New trips brought doctors, but there is no file left giving the names of the
doctors who arrived. It was not until the year 1583 that a surgeon named Don Miguel
Gerónimo resided in Caracas and devoted himself entirely to the exercise of his art in
the beautiful city of Ávila.

The principle of medicine in Venezuela results from a mixture of the Piache

rites and the empirical knowledge of European experts. Transculturation did not
completely absorb the indigenous people, but on the contrary, the conquerors had to use
“cultural borrowings” taken from the natives, particularly in terms of the medical point
of view and hence the mixed character of our colonial medicine in its origins. As was
the use of numerous plant substances, animal origin and even minerals used and that
have persisted in our town, as part of that folklore medicine. Such is the case of the first
Venezuelan cultural mestizo, Francisco Martín, who came on the Alfinger expedition,
when, having crossed the Sierra de Coro, he got lost in it and arrived at an Indian town,
being changed owners and then sold as a slave to a Pemones tribe on the shores of Lake
Maracaibo. There he learned the trade of piache, so his fame spread. Another healer
who acquired even more fame was Don Diego de Public health in Venezuela, its
historical evolution, current state and proposals Briceño-Iragorry L, González Reyes MJ
363 Montes, from Madrid, known as “El Venerable”. He cured the
conqueror Hutten of a chest wound, using an ingenious trick; He reproduced the wound
on an old Indian and then, making sure not to compromise an important viscus,
expanded the one the German had in the armpit and quickly healed him. First concrete
news of a surgical act, if you like the first vivisection of colonial times.

Characters like Alfinger, Federmann, Spira, Hutten suffered the onslaught of

illnesses. Without a doubt, the Captains of the Belzars were the most punished. The
pathological picture can be summarized in the following diseases: smallpox, measles,
dysentery, fevers, bubas, ulcers, myiasis and diseases caused by arthropods. The
military health of that time described by Bernardo de Vargas Machuca in his book
Militia and description of the Indies, from 1599, the indigenous influence on Spanish
medicine is observed once again, evident in the use of numerous American plant
substances.

In 1602, the Cabildo of Caracas approved the construction of a hospital that

would be named San Pablo because it was next to the Church of San Pablo. It was
located in the southern part of the city, near the Caroata ravine. To the east it bordered
the temple of San Pablo and to the west with the Women's Charity hospice and hospital,
to the north with San Pablo Square and to the south with several tenement houses. The
sick poor were housed there, as was usual at that time. In its spaces it came to have
several rooms, including the room for the common sick or also called countrymen, the
anointing room, the ethics room, and a room for smallpox patients, also called St.
Joseph's room. The main room, was located in front of the building overlooking the
Plaza de San Pablo, measured 41 yards long by 7 yards wide, and was used to house up
to Public health in Venezuela, its historical evolution, current state and proposals
Briceño- Iragorry L, González Reyes MJ 365 44 beds in it. The San Pablo Hospital was
exclusively for men, and acquired a civic-military character in the 18th century, with
both civilian and military patients being found, and in 1751 a special room was built for
the latter. Under the administration of the butler Gonzalo Quintana Barreto (1759-1777)
the hospital progressively increased its capacity to house patients, already in 1770 the
number of beds was 50, reaching an even greater number with the presence of military
patients.

In 1691, the Nuestra Señora de la Caridad Hospital was founded, attached to the
San Pablo Hospital, as a women's shelter, fulfilling the double function of hospice and
care for patients, being the first with these functions. Its functions lasted until 1891
when the patients were transferred to the newly inaugurated Vargas Hospital. For the
years 1750 (its exactness is not well defined) the foundation of the Royal Hospital of
San Lázaro was decreed, as its name indicates to house leper patients. It was initially
located near the Plaza de La Candelaria (corners of San Lázaro to Puente Victoria). This
Hospital was later moved to the northeast of the city (Sarria). It was the first hospital
with its own ordinances, drawn up in 1760. Historically, this would be one of the first
hospital regulation projects in Venezuela.

It was in 1768 when the Mayor of the San Pablo Hospital was empowered to
carry out a national survey, with subsequent authorization to formulate the pertinent
measures regarding material progress and administrative uniformity thereof. Higher
level studies begin with “the magnificent, Royal and Seminary of Santa Rosa de Santa
María de Lima in Santiago de León, Caracas”, inaugurated at the end of the 17th
century (1696), such was the seed that later became the Royal and Pontifical University
of Caracas, activities that began in 1725. The creation of medical studies in Venezuela
is due to the Mallorcan doctor Lorenzo Campins y Ballester (1763), starting the chair
with just 4 students; The first courses failed and it was only after twelve years that he
was able to see the fruit of his efforts with the degree of two of his disciples, Francisco
José Molina in 1775 and Rafael Córdoba Verde in 1782.

Being the substitute of Campins, Molina when he fell ill in 1783, in the teaching
of medicine, this being the first doctorate in Medical Sciences of our University and the
first Venezuelan who had the honor of being both a professor of Prima Medica and
Protomedicine. . He died shortly after and was replaced by Felipe Tamariz from
Caracas, who ran the chair for 27 years. He was then succeeded by José Joaquín
Hernández, being replaced by perhaps the most eminent Venezuelan doctor, Doctor
José María Vargas. In the period between 1800 and 1810, marking the period between
the end of the Colony and Independence, the City Medication (14) was created, an
organization designed to cover public medical assistance (1802); His first doctor was
Dr. José Domingo Díaz, who was already a doctor at different hospitals such as San
Lázaro and San Pablo. Their assignments included: 1st free assistance to the solemn
poor, to the sick of the House of Mercy. 2nd authorization to enter houses where
contagious patients are suspected. 3rd epidemiological fight activities. 4th quarterly
periodic reports related to the state of local health and 5th Public health in Venezuela,
its historical evolution, current state and proposals Briceño-Iragorry L, González Reyes
MJ 367 execution of what the Government orders by official letter. In this period, the
Balmis expedition arrived in Venezuela (1804), which marked a milestone in the
introduction of the Vaccine in Venezuela.

Diseases such as malaria, yellow fever, dysentery and vitamin deficiencies

decimated the armies. There was a military health regime as stated in reports from our
generals. It should be noted that the Liberator, prior to the Battle of Carabobo,
introduced the (prophylactic) use of quinine liquor to prevent malaria. In June 1827,
the Liberator Simón Bolívar, in his capacity as President of Gran Colombia, issued the
decree creating the Faculty of Medicine of the University of Caracas. In addition to
granting it the status of a court for professional matters and the governing body of
university medical studies, the aforementioned decree confers on the Faculty of
Medicine specific powers related to “public health.”

The renaissance of medicine in Venezuela is marked with the creation of the

Vargas Hospital in Caracas. It was up to President JP Rojas Paúl to resume the
development of public health. This was not an isolated event, but part of an effort to
comprehensively develop public capacity for health care.

The Hospital Gazette was created, where statistics, resolutions, regulations, etc.
were reflected, but this body lasted a very short time. Castro created the Directorate of
Hygiene and Demographic Statistics in 1899, which established: “Urban cleanliness as a
public service, constant inspection of food, meat and milk and surveillance of markets
and slaughterhouses, shipments of food samples to the Bacteriology Laboratory of the
Vargas Hospital and publication in the Caracas Medical Gazette of the monthly data
regarding morbidity in the city of Caracas.”

Unfortunately, this flowering of medicine became somewhat stagnant at the

beginning of the 20th century, during the presidential period of General Gómez. Private
initiative and social concern regarding private hospitals and clinics (Policlínicas
Caracas, Córdoba and Razetti). The number of beds to meet the country's needs was
insufficient. Charitable Boards or Societies were created for the construction of new
hospitals; in Ciudad Bolívar a model hospital with a nursing school, under the
supervision of an Administrative Board, headed by Dr. Félix R. Paez. List of Hospitals
built in the first 35 years of the 20th century (20) (sic): “San Antonio” Hospital in
Altagracia de Orituco 1910 “Pedro Justo” Hospital in Rubio, 1904 “San Antonio”
Hospital in El Tocuyo, 1906 Psychiatric Hospital of Maracaibo, 1907 Leprocomium of
Cabo Blanco, Maiquetía, 1906 “San Antonio” Hospital of Carora, 1902 “Jesus
Crucified” Hospital of Upata, 1917 “Acosta Ortiz” Hospital San Fernando de Apure,
1918 “Antonio María Pineda” Hospital Barquisimeto, 1918 “Egidio Montesinos”
Hospital El Tocuyo, 1919 Hospital and Clinic for Poor Children, Maracaibo, 1919
Razetti Collection. Volume XX. 370 Díaz Bruzual A, López Loyo E. “Santa Rosa”
Tumeremo Hospital, 1920 “Our Lady of Peace” Valera Hospital, 1922 “San Antonio”
Táriba Hospital, 1925 “Vargas” San Cristóbal Hospital, 1927 “Caribbean” Mene
Grande Hospital, 1928 Cumaná Red Cross Hospital, 1929 “Caribbean” Hospital of
Maracaibo, 1930 Pro-infant Institute of Maracaibo, 1932 “Simón Bolívar” Hospital Rio
Caribe, 1932 Children's Hospital of Barquisimeto, 1934 Hospital of Tucupita, 1934
“Los Andes” Hospital Mérida, 1935.

The creation in the newly inaugurated Ministry of Health and Social Assistance
in 1936, of a special unit in charge of hospital policy, with the name of Hospital
Division (later, Hospital Institute) where the criterion of modern technology of
healthcare was imposed. projects and the consistent administration of hospitals. With
the construction of new hospitals, as evidenced, in Caracas with the Simón Bolívar
Anti-Tuberculous Sanatorium, the University Hospital, the Concepción Palacios
Maternity Hospital and the Children's Hospital; In the interior of the Republic, the
Miguel Oraá Hospital of Guanare, the Surgical Hospital, the Maternity Hospital of
Maracaibo and the Central Hospitals of the main capitals of the Republic.

In 1935 the number of hospitals was just over 50 throughout the national
territory. By 1962 there was an entire network made up of 315 hospital centers with
27,500 beds. Specifying: 65 MSAS dependents with 15,500 beds; 75 state-owned with
3,334 beds and 278 administered by different entities with 8,602 beds (20).

The long period of predominance of public health as a right and state

responsibility, beginning in 1936, ending in the 60s, resulted in the development of an
efficient network of health services, control of rural diseases, expansion of coverage,
especially rural , training of talents both clinically and in public health, in Public health
in Venezuela.