The view from the ground.

Cancer Ward

With Hugo Chavez ailing, Venezuelans are just starting to realize how dependent they've become on him.

Venezuelan President Hugo Chavez kisses a Venezuelan national flag at Miraflores presidential palace in Caracas on July 4, 2011. Chavez returned to Venezuela Monday after spending three weeks in Cuba, where he had a cancerous tumor extirpated. AFP PHOTO/Juan BARRETO (Photo credit should read JUAN BARRETO/AFP/Getty Images)

CARACAS — Marianela Hernandez’s biggest worry used to be finding cooking oil and meat in her working-class neighborhood here in the Venezuelan capital.

That was before Venezuelan President Hugo Chávez decamped to Havana, Cuba, for mysterious medical treatment and belatedly announced late last month, after returning to Caracas, that he has cancer. Now Hernandez has far more pressing concerns: the president’s health and the turmoil that awaits if he doesn’t recover.

"If El Comandante can’t continue, what will we do?" said Hernandez, a 55-year-old office cleaner. "What will happen to the programs he started, his support for the people? What will happen to us?"

She’s not the only one obsessed with the president’s illness: Venezuela has virtually stopped paying attention to anything else. The 200th anniversary of the country’s founding on July 5 has been crowded out of the popular imagination, as have the remarkable recent successes of the national soccer team in Copa America in Argentina.

This outsize influence in sickness matches Chávez’s larger-than-life presence in health. Unlike any other leader in Venezuela’s democratic history, Chávez has dominated daily life, steadily amassing power by eroding the autonomy of the country’s political institutions. Since being sworn in as president in 1999, Chávez has actively sought to change the country’s political, social, and economic realities, leading many of his followers to portray him as the country’s messianic savior.

Chávez draws the bulk of his support from the country’s poor who make up 80 percent of the country’s 28 million population. They support the president because of his popular affect, but also simply because they benefit from the social programs he has introduced — free housing and low-interest loans.

That’s not to say that Venezuelans are universally hoping for a speedy recovery. Roberto Carmona, an out-of-work computer programmer, is baffled by the prevalent hand-wringing. "He’s ruining the country with his policies, so I hope he has to step down. Maybe I can find a job when companies start investing again. But I wouldn’t count him out just yet," Carmona said, sighing. "As we say here, mala hierba nunca muere [weeds never die]."

The president has been uncommonly reticent about his condition: This is a man, after all, who once on his Sunday television show, Aló Presidente, discussed a bout of diarrhea he had recently suffered. Chávez has long admitted that he hasn’t been taking good care of himself, blaming late-night snacking (poundcake is apparently a favorite) for his ballooning weight.

In early July, Chávez admitted that doctors had removed a cancerous tumor from his abdomen on June 20 and that a program of chemotherapy had been initiated four days later. Since then, Vice President Elías Jaua has only said that Chávez is undergoing "rigorous treatment" and that "the president is moving along in his process." He gave no further details.

It’s this kind of piecemeal and inconsistent communication from the government about Chávez’s health that has fed the rampant public speculation. While Chávez stonewalls, his few and carefully orchestrated public appearances are viewed over and over for possible clues about his health as he receives treatment in Caracas.

Many Venezuelans have been willing to offer amateur diagnoses on the basis of such photographic evidence. "He looks paler now and speaks more slowly," said Nora Alvarez, a 32-year-old housewife who has never voted for Chávez. "He looks thinner and less animated. He’s not the same man." She is convinced that Chávez is dying because he has abandoned his habit of ending all speeches with the words Patria, Socialismo o Muerte (Fatherland, Socialism, or Death).

"He doesn’t want to tempt fate," she said.

Forget dying. Not everyone believes that Chávez has cancer. Some think that his illness may be a sham to gain sympathy in the run-up to next year’s election. Chávez remains the country’s most popular politician, with an approval rating of about 50 percent — though that marks a decline from 2006, when he received more than 60 percent of the votes.

"He could have had liposuction in Cuba for all we know," said Santiago Cruz, who owns a pet store in Caracas. "This whole cancer thing could be a fabrication, something that Fidel [Castro] could have counseled him to do. The fact is we have no idea what he really has."

Given that he is 56 years old and the tumor was located in his abdomen, some doctors have speculated that Chávez may be suffering from advanced colon or prostate cancer, a diagnosis that would require aggressive therapy if he is to survive at all.

Increasingly, opposition politicians are calling for full disclosure; the government has responded with silence.

The uncertainties have clouded the multiple parades and festivals marking the bicentennial of Venezuelan independence from Spain. Millions of dollars were spent sprucing up the historical center in Caracas and hosting scores of cultural events. Chávez also scheduled a meeting of regional leaders to coincide with the anniversary, a summit that he had to postpone while he was still undergoing treatment in Cuba.

Although the state television channel constantly shows supporters shouting "Pa’lante Comandante!" (Move forward, Commander!) as they wish Chávez well, announcers often seem at a loss for words to explain the president’s absence.

Instead, Chávez has been forced to participate in the festivities at a distance, sending occasional tweets that some in the opposition suspect are being sent entirely unbeknownst to the ailing president. Still, since returning to Caracas on July 4, he has tried to project an air of authority by appearing in public with the military high command.

That has also served to dispel rumors of possible dissension in the upper echelons of government. Indeed, part of the reason Chávez is staying silent may be that he’s trying to avoid infighting within his United Socialist Party of Venezuela. The party is split between two groups, with dogmatists grouped around Chávez’s brother Adán, and more pragmatic members backing former Vice President Diosdado Cabello. A grave diagnosis for the leader could spark an intraparty civil war, as the factions vie for command of a post-Chávez government. That in turn would only help the opposition.

Still, Venezuela is a different place without the president’s ubiquitous presence. Prior to his illness, he dominated the country’s television and radio airwaves, sometimes holding one or two national addresses a day that pre-empted all other programming. And, of course, his photograph is nearly ubiquitous. Pictures of the president abound: Travelers arriving at Caracas’s Símon Bolívar International Airport are bombarded with posters of a smiling Chávez highlighting his revolution’s accomplishments. Similar photos greet Venezuelans all around the country.

Now, his abrupt illness has created a vacuum that his vice presidents and ministers seem unable and unwilling to fill. Without Chávez to lead, many wonder how long his movement will continue.

"Chavismo without Chávez won’t last long," said Carmona.

Investors seem to agree. Venezuelan bond prices have risen 11 percent since the crisis began as buyers have stoked demand, thinking that any change in government would see a repeal of the many Chávez-backed initiatives and forced nationalizations that hindered private-sector investment and made Venezuela an unreliable business partner under his leadership.

One thing that Chávez’s illness has again underlined is how deeply divided the country is. Although Chávez remains the country’s most popular politician (with an approval rating near 50 percent), his policies are rejected by two out of every three Venezuelans. More than half also say it is time to let someone else run Venezuela.

Crime is soaring — as is the country’s debt. Chávez has borrowed heavily to finance his social programs for public transportation and health care. A new currency that Chávez introduced more than two years ago has already lost more than half its value, and consumer prices rose 13 percent in the first six months of this year, the fastest pace in Latin America. Oil production, which accounts for 90 percent of the country’s exports, has fallen by one-third since 1999, a poor record for a country that claims to have the world’s largest reserves.

So far, the opposition has shown uncharacteristic restraint, refraining from attacking Chávez while he’s down and instead concentrating its focus on next year’s elections. If the president’s health worsens, though, that restraint is unlikely to last. And that is where problems could arise, especially if his backers try to force a less than orderly and constitutional transition.

"With society so polarized and with so many guns on the street, there could be a civil war if he dies," said Carmen Soto, who heads a government-backed local council intended to foster grassroots democracy. "This is a recipe for disaster."

Peter Wilson, a freelance journalist who recently left Venezuela after 24 years, is writing a book about Hugo Chávez and his failed socialist revolution.

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