Cancer at the Heart

CARACAS, Venezuela — Belkis Martinez isn’t taking any chances. Minutes after hearing that Venezuelan President Hugo Chávez was leaving for Cuba for another round of medical treatment, the 42-year-old hairstylist who lives in Antímano, a working-class neighborhood of Caracas, was in line at her supermarket buying canned goods and crackers.

"I just can’t help but think that they aren’t telling us the real story about El Comandante," said Martinez, referring to the president. "If something would happen to him, anything could happen. His enemies could try to take power, or maybe people within in his own party would try. I just want to be prepared for the worst, especially if rioting breaks out or they declare martial law."

The Venezuelan president’s return to Havana for additional medical care comes as he seeks to deepen the country’s socialist revolution after winning a new six-year term on Oct. 7. Chávez, who has been battling cancer since June 2011, won 55 percent of the vote, compared with 44 percent for the governor of Miranda state, Henrique Capriles Radonski. He has repeatedly said the vote was a mandate for him to expand socialism in the country, and opponents fear that he may seek to restrict personal freedoms and place fresh limits on private property. But without Chávez leading the revolution, few believe that his successors will have any luck fulfilling his agenda.

Speculation about Chávez’s health has been growing since he won reelection and then dramatically cut back his public appearances. According to figures compiled by the Caracas-based El Universal newspaper, Chávez amassed 2,850 minutes’ worth of public appearances in July, including campaign and government activities, interviews, news conferences, and televised telephone calls. In August and September, the totals were 3,730 minutes and 2,466 minutes, respectively, but in October, the president’s appearances slumped to 879 minutes. In November to date, they have fallen to a mere 495 minutes. For Venezuelans accustomed to hearing Chávez’s characteristically long-winded speeches several times a week, his absence is tangible.

Chávez’s health remains shrouded in mystery — he has repeatedly refused to divulge details about his illness — but he has admitted to undergoing three pelvic surgeries, including one to extract a tumor. In September, the president publicly broke down and implored God to allow him to live longer, fueling already rampant speculation that his condition is terminal. Chávez’s struggle has spawned at least one website dedicated to tracking changes in his health. Still, Chávez’s Nov. 28 departure for Cuba surprised many, given its timing.

The trip coincided with a military parade celebrating the 20th anniversary of his second unsuccessful coup against then-President Carlos Andrés Pérez — a parade he had been scheduled to attend. It also occurred less than three weeks before Venezuelans are scheduled to go to the polls for gubernatorial and state elections. Chávez had been expected to campaign for candidates of his United Socialist Party of Venezuela (PSUV), several of whom are facing stiff challengers.

The president has not been seen since he appeared at a carefully choreographed televised meeting with ministers on Nov. 15. At that time, he seemed animated, but his face was palpably swollen. Rumors of his imminent demise and possible political instability helped push the black-market dollar rate to a record high 20 bolívars briefly this week, before it fell back to 15. The official exchange rate is 4.3 bolívars to the dollar. Adding to the uncertainty is the fact that Chávez left the country under a cloud of secrecy. In the past, his health-related travels have been broadcast live on television. This time, however, he left it to Diosdado Cabello, president of the Venezuelan National Assembly, to read a short statement announcing his departure.

According to the statement, Chávez requested the assembly’s permission to leave the country for more than five days — as spelled out in the Venezuelan Constitution — for physical therapy and hyperbaric oxygenation treatment. Such treatment, which consists of breathing pure oxygen under pressurized conditions, is often prescribed for post-surgical patients to speed their recovery. Its use for cancer patients, however, is more controversial, as the pure oxygen can also feed cancerous cells, allowing them to grow more rapidly.

Cabello, a former vice president and one of Chávez’s closest collaborators, did not offer a specific date for Chávez’s expected return. Instead, he assured the public that the president would be back in time for his inauguration ceremony on Jan. 10. Information Minister Ernesto Villegas subsequently said that Chávez started treatment upon arrival in Cuba and that the procedures were cancer-related. He further explained that the president’s condition had been exacerbated by campaigning. "He didn’t follow the advice of those who told him not to campaign,” said Villegas. "He did, and like the extraordinary political leader that he is, he made an effort."

Since his initial treatment, Chávez has made at least 16 health-related trips to Cuba. He is also widely suspected of having made several undisclosed stops for medical care. Rejecting advice from friends such as former Brazilian President Luiz Inácio Lula da Silva, Chávez has refused to seek treatment outside Cuba, fearing that his medical condition could be leaked to the media if he did.

Just six months ago, in the heat of the presidential campaign, Chávez claimed that he was cancer-free, after at least three operations as well as chemotherapy and radiotherapy. Still, Chávez often looked heavily made up and tired with noticeable facial swelling during the campaign. That he didn’t look worse was attributed to his rumored use of steroids to maintain his strength and physical appearance.

But not everyone is convinced that Chávez is on his deathbed. "I just think his departure to Cuba is yet another ruse to gain votes for the PSUV and their candidates in the upcoming elections,” said Javier Rojas, a chemical engineer in Caracas. "He has relapses every time he needs support or votes from the masses, who don’t question him or his motives. I don’t think he is sick at all."

Under the Venezuelan Constitution, Vice President Nicolás Maduro would assume power if Chávez were unable to serve. But Maduro, who was only named vice president last month, is regarded by many as an uninspiring leader, lacking Chávez´s political skills. And cracks in Chávez´s ruling PSUV have already appeared as rumors about his condition have spread.

At the state level, Chávez’s decision to seek treatment in Cuba could have real political consequences, whether or not he recovers. In several states, the president’s backers have been unable to unite around a single gubernatorial candidate, leading Cabello to castigate party officials. Venezuela’s opposition currently holds seven of the country’s 23 statehouses. And after the presidential vote, in which the opposition did remarkably well, many of these races are seen as wide open.

At his inauguration in January, Chávez is expected to spell out initiatives for deepening the revolution through 2019. Among them could be new nationalizations, a possible devaluation, and the abolition of state and regional governments in favor of peoples’ communes. "I am afraid of what may happen to Chávez between now and then," said Giovanna Lozada, who owns a boutique in Caracas. "But I think I am more scared as to what the president may say on Jan. 10."