BARCELONA, Venezuela — By morning, three newborns were
already dead.
The day had begun with the usual
hazards: chronic shortages of antibiotics, intravenous solutions, even food.
Then a blackout swept over the city, shutting down the respirators in the
maternity ward.
Doctors kept ailing infants alive by
pumping air into their lungs by hand for hours. By nightfall, four more
newborns had died.
“The death of a baby is our daily
bread,” said Dr. Osleidy Camejo, a surgeon in the nation’s capital, Caracas,
referring to the toll from Venezuela’s collapsing hospitals.
The economic crisis in
this country has
exploded into a public health emergency, claiming the lives of untold numbers
of Venezuelans. It is just part of a larger unraveling here that has become so
severe it has prompted President Nicolás Maduro to impose a state of emergency
and has raised fears of a government collapse.
Hospital wards have
become crucibles where the forces tearing Venezuela apart have converged.
Gloves and soap have vanished from some hospitals. Often, cancer medicines are
found only on the black market. There is so little electricity that the
government works only two days a week to save what energy is left.
At
the University of the Andes Hospital in the mountain city of Mérida, there was
not enough water to wash blood from the operating table. Doctors preparing for
surgery cleaned their hands with bottles of seltzer water.
“It is like something
from the 19th century,” said Dr. Christian Pino, a surgeon at the hospital.
The figures are
devastating. The rate of death among babies under a month old increased more
than a hundredfold in public hospitals run by the Health Ministry, to just over
2 percent in 2015 from 0.02 percent in 2012, according to a government report
provided by lawmakers.
The rate of death
among new mothers in those hospitals increased by almost five times in the same
period, according to the report.
Yulitza Roa, 15, who has a brain tumor, is awaiting surgery that has been delayed because Luis Razetti Hospital does not have the needed scanning equipment.CreditMeridith Kohut for The New York Times
Here in the
Caribbean port town of Barcelona, two premature infants died recently on the
way to the main public clinic because the ambulance had no oxygen tanks. The
hospital has no fully functioning X-ray or kidney dialysis machines because
they broke long ago. And because there are no open beds, some patients lie on
the floor in pools of their blood.
It is a
battlefield clinic in a country where there is no war.
“Some come
here healthy, and they leave dead,” Dr. Leandro Pérez said, standing in the
emergency room of Luis Razetti Hospital, which serves the town.
This nation
has the largest oil reserves in the world, yet the government saved little
money for hard times when oil prices were high. Now that prices have collapsed
— they are around a third what they were in 2014 — the
consequences are casting a destructive shadow
across the country. Lines for food, long a feature of life in
Venezuela, now erupt into looting. The bolívar, the country’s currency, is
nearly worthless.
The crisis is
aggravated by a political feud between Venezuela’s leftists, who control the
presidency, and their rivals in
congress. The president’s opponents declared a humanitarian crisis in January,
and this month passed a law that would allow Venezuela to accept international
aid to prop up the health care system.
“This is
criminal that we can sit in a country with this much oil, and people are dying
for lack of antibiotics,” says Oneida Guaipe, a lawmaker and former hospital
union leader.
But Mr.
Maduro, who succeeded Hugo Chávez, went on television and rejected the effort,
describing the move as a bid to undermine him and privatize the hospital
system.
“I doubt that
anywhere in the world, except in Cuba, there exists a better health system than
this one,” Mr. Maduro said.
Late last
fall, the aging pumps that supplied water to the University of the Andes
Hospital exploded. They were not repaired for months.
So without
water, gloves, soap or antibiotics, a group of surgeons prepared to remove an
appendix that was about to burst, even though the operating room was still
covered in another patient’s blood.
A protest last month in Caracas, Venezuela, over the country’s hospital crisis.CreditMeridith Kohut for The New York Times
“There are people dying for lack of medicine, children
dying of malnutrition and others dying because there are no medical personnel,”
said Dr. Yamila Battaglini, a surgeon at the hospital.
Yet even among
Venezuela’s failing hospitals, Luis Razetti Hospital in Barcelona has become
one of the most notorious.
In
April, the authorities arrested its director, Aquiles Martínez, and removed him
from his post. Local news reports said he was accused of stealing equipment
meant for the hospital, including machines to treat people with respiratory
illnesses, as well as intravenous solutions and 127 boxes of medicine.
Around 10 one recent
night, Dr. Freddy Díaz walked down a hall there that had become an impromptu
ward for patients who had no beds. Some clutched blood-soaked bandages and
called from the floor for help. One, brought in by the police, was handcuffed
to a gurney. In a supply room, cockroaches fled as the door swung open.
Dr. Díaz logged a
patient’s medical data on the back of a bank statement someone had thrown in
the trash.
“We have run out of
paper here,” he said.
On the fourth floor,
one of his patients, Rosa Parucho, 68, was one of the few who had managed to
get a bed, though the rotting mattress had left her back covered in sores.
But those were the
least of her problems: Ms. Parucho, a diabetic, was unable to receive kidney
dialysis because the machines were broken. An infection had spread to her feet,
which were black that night. She was going into septic shock.
Ms. Parucho needed
oxygen, but none was available. Her hands twitched and her eyes rolled into the
back of her head.
“The bacteria aren’t
dying; they’re growing,” Dr. Díaz said, noting that three of the antibiotics
Ms. Parucho needed had been unavailable for months.
He paused. “We will
have to remove her feet.”
Three relatives sat
reading the Old Testament before an unconscious woman. She had arrived six days
before, but because a scanning machine had broken, it was days before anyone
discovered the tumor occupying a quarter of her frontal lobe.
Photo
Lisquer Pulido, 17, left, and Marilin Mago, 25, waiting last month to enter the neonatal area of the maternity ward at a hospital in Puerto La Cruz to feed their premature babies who had been born that week.CreditMeridith Kohut for The New York Times
Samuel Castillo, 21, arrived in the emergency room
needing blood. But supplies had run out. A holiday had been declared by the
government to save electricity, and the blood bank took donations only on
workdays. Mr. Castillo died that night.
For
the past two and a half months, the hospital has not had a way to print X-rays.
So patients must use a smartphone to take a picture of their scans and take
them to the proper doctor.
“It looks like
tuberculosis,” said an emergency room doctor looking at the scan of a lung on a
cellphone. “But I can’t tell. The quality is bad.”
Finding medicine is
perhaps the hardest challenge.
The pharmacy here has
bare shelves because of a shortage of imports, which the government can no
longer afford. When patients need treatment, the doctors hand relatives a list
of medicines, solutions and other items needed to stabilize the patients or to
perform surgery. Loved ones are then sent back the way they came to find
black-market sellers who have the goods.
The same applies to
just about everything else one might need here.
“You must bring her
diapers now,” a nurse told Alejandro Ruiz, whose mother had been taken to the
emergency room.
“What else?” he asked,
clutching large trash bags he had brought filled with blankets, sheets, pillows
and toilet paper.
Nicolás Espinosa sat
next to his tiny daughter, who has spent two of her five years with cancer. He
was running out of money to pay for her intravenous solutions. Inflation had
increased the price by 16 times what he paid a year ago.
He flipped through a
list of medicines he was trying to find here in Barcelona and in a neighboring
city. Some of the drugs are meant to protect the body during chemotherapy, yet
the girl’s treatments ended when the oncology department ran out of the
necessary drugs a month and a half ago.
Near
him, a handwritten sign read, “We sell antibiotics — negotiable.” A
black-market seller’s number was listed.
Biceña Pérez, 36,
scanned the halls looking for anyone who would listen to her.
“Can someone help my
father?” she asked.
Photo
The pediatric emergency room of a government-run clinic in Catia La Mar.CreditMeridith Kohut for The New York Times
Her father, José Calvo, 61, had contracted Chagas’
disease, a sickness caused by a parasite. But the medication Mr. Calvo had been
prescribed ran out in his part of Venezuela that year, and he began to suffer
heart failure.
Six hours after Ms.
Pérez’s plea, a scream was heard in the emergency room. It was Mr. Calvo’s
sister: “My darling, my darling,” she moaned. Mr. Calvo was dead.
His daughter paced the
hall alone, not knowing what to do. Her hands covered her face, and then
clenched into fists.
“Why did the director
of this hospital steal that equipment?” was all she could say. “Tell me whose
fault is this?”
The ninth floor of the
hospital is the maternity ward, where the seven babies had died the day before.
A room at the end of the hall was filled with broken incubators.
The glass on one was
smashed. Red, yellow and blue wires dangled from another.
“Don’t use —
nonfunctional,” said a sign dated last November.
Dr.
Amalia Rodríguez stood in the hallway.
“I had a patient just
now who needed artificial respiration, and I had none available,” Dr. Rodríguez
said. “A baby. What can we do?”
The day of the power
blackout, Dr. Rodríguez said, the hospital staff tried turning on the
generator, but it did not work.
Doctors tried
everything they could to keep the babies breathing, pumping air by hand until
the employees were so exhausted they could barely see straight, she said. How
many babies died because of the blackout was impossible to say, given all of
the other deficiencies at the hospital.
“What can
we do here?” Dr. Rodríguez said. “Every day I pass an incubator that doesn’t
heat up, that is cold, that is broken.”
Ana León and Meridith Kohut contributed reporting from Barcelona, and Patricia Torres from Caracas, Venezuela.
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