Overcrowded shelters, disease outbreaks, and lack of clean water pose health risks to thousands after Venezuela quakes

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Venezuela has opened more than 80 shelters for those whose homes were destroyed in twin quakes on June 24, with the number of displaced reaching 17,907 by Thursday.

Poor shelter conditions could leave many survivors especially vulnerable, the Pan American Health Organisation (PAHO) Director Jarbas Barbosa said.

"In the coming weeks, the greatest health risks may stem not only from injuries caused by the earthquakes, but also from disruptions to health services, overcrowded conditions, deficiencies in water and sanitation and reduced access to vaccination and routine healthcare," Barbosa said.

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PAHO will work with Venezuela's health ministry to monitor for potential outbreaks of respiratory or digestive illnesses and is urging access to vaccines, said Barbosa, who is also WHO Regional Director for the Americas.

It will also work with the government to incorporate field hospitals and shelters into an early warning system tracking diarrheal diseases, respiratory infections, febrile syndromes and vaccine-preventable illnesses.

Tom Fletcher, the United Nations' top humanitarian official, told Reuters that the disaster caused by the consecutive earthquakes, with magnitudes of 7.2 and 7.5, would be "incredibly difficult for any government in the world" to manage.

The United Nations is aiming to reach 1.3 million people in the next six months who are most critically in need of humanitarian support.

Authorities raised the death toll on Thursday to 3,889, while the number of injured remained at 16,740.

Asked whether these government's casualty figures were reliable, Fletcher said it was very hard to say given the incredibly chaotic nature of the disaster.

While residents have criticised a slow state response, Fletcher said a UN coordination cell established with the government has been working well to facilitate international aid.

The UN has already mobilised over $300 million in coordinated support, said Fletcher, adding that nearly 40,000 people have already received food aid in the two weeks since the response began.

The UN is also deploying teams to provide psychosocial support to survivors, particularly women and children.

Venezuela's health system has deteriorated significantly after years of economic crisis, contributing to a lack of immediate care after the quakes, said Ciro Ugarte, PAHO's director for health emergencies.

The migration of healthcare professionals in recent years - part of broader waves of people leaving the country - also left Venezuela in a difficult position.

"The shortage of essential services in the immediate aftermath was critical, and facilities that had not been intended for trauma care or emergency patient treatment had to be adapted for that purpose throughout Venezuela," Ugarte said.

Care has improved with international assistance, personnel from other regions and field hospitals, he said.

Acting Venezuelan President Delcy Rodriguez has defended the government's handling of the quakes amid criticism that civilians have led many of the rescue and recovery operations, with the help of professional rescue teams from around the world, firefighters and army volunteers.

Three hundred victims in La Guaira, the hardest-hit state, were buried without being identified, but Venezuela's forensic service is keeping records to allow for matches at a later time, said Armando De Negri, PAHO's acting director in Venezuela.

"The exact location where they are buried is recorded, and material currently being collected - such as teeth, bones and fingernails, which provide stable genetic material - is preserved and archived," he said. "All are in coffins, all have been handled properly."