Standing water and unsanitary conditions at mine sites have exponentially increased water- and mosquito-borne disease in the local population. Although Venezuela was the first country in Latin America to eradicate malaria, the disease has returned at an astonishing rate. The WHO reported 323,392 cases of malaria in Venezuela between January and October 2019, and 10 percent of the population in Bolivar state has tested positive for the disease. Malaria causes 21 percent of deaths in Amazonas state and 25 percent of deaths in Bolivar state; medication is often difficult to procure, although it is available for purchase with gold on the black market. Conditions near the mines have also contributed to spikes of diphtheria, yellow fever, dengue, and chikungunya. Moreover, as mercury from mining has seeped into the soil and water systems, local indigenous populations have been exposed at dangerous levels. In the Caura river basin, a tributary to the Orinoco, 92 percent of indigenous women had elevated levels of mercury, which could damage the kidney and brain and impedes fetal development.