In recent years, amid profound shortages of medicine coupled with widespread ignorance, H.I.V. has spread rapidly throughout the Orinoco Delta and is believed to have killed hundreds of the Warao indigenous people who live in settlements like Jobure de Guayo along the serpentine channels winding through this swampy, forested landscape.
Even under the best of circumstances, it might be difficult to control the disease’s spread in such an isolated and deprived area. But the government has ignored the issue, medical specialists and Warao community leaders say, leaving the population to face a profound existential threat alone. Already, deaths and the flight of survivors have gutted at least one village.
Dr. Jacobus de Waard, an expert on infectious diseases at the Central University of Venezuela, who has worked and traveled among the Warao for years, said that nothing less than the future of the ancient culture was at stake.
“If there’s no intervention, it’s going to affect the existence of the Warao,” he warned. “A part of the population is going to disappear.”
The epidemic plaguing the Warao is a crisis within a crisis, a dramatic example of how Venezuela is failing to grapple with a resurgent AIDS emergency even as the annual numbers of new H.I.V. infections and AIDS-related deaths around the world continue to decline.
Under President Hugo Chávez, Venezuela’s H.I.V./AIDS prevention and treatment program was world class and the country seemed to have the disease under control.
But during the presidency of Nicolás Maduro, which began in 2013, Venezuela’s economy has crumbled, causing crippling shortages of medicine and diagnostic tests, and compelling many of the country’s best doctors to emigrate.
The government has even stopped distributing free condoms, which can help prevent the spread of H.I.V., activists say. The price for a pack can cost the equivalent of several days’ pay at minimum wage.
The government’s inaction, the activists say, is especially egregious considering that President Maduro — like his predecessor — has cast himself as a champion of the nation’s indigenous people.
The Maduro administration did not respond to requests for interviews with officials of the national H.I.V. prevention program, the health ministry and the ministry of indigenous affairs.
The government has released health statistics only sporadically in recent years, and doctors often dispute their accuracy. But AIDS activists and specialists say that H.I.V. infection rates and the number of AIDS-related deaths have skyrocketed. So, too, has the number of once stable H.I.V. patients whose health has collapsed for lack of a regular supply of antiretroviral drugs and medicines to treat opportunistic diseases.
“It’s a humanitarian emergency — we have to be very emphatic,” insisted Jhonatan Rodríguez, president of StopVIH, a Venezuelan activist group.
Among the most disadvantaged Venezuelans, he said, are the Warao.
“It’s a population that has been totally neglected.”