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More than a decade ago, the country was lauded for its treatment program. Now, Venezuela is years into a political and economic crisis
Under Nicolás Maduro, a country that had been one of Latin America’s wealthiest is having its democratic institutions shredded amid rising poverty and corruption.
WSJ BY DAVID LUHNOW AND JOSÉ DE CÓRDOBA
Venezuela is seeing its democratic institutions collapse, leading to levels of disease, hunger and dysfunction more often seen in war-torn nations than oil-rich ones. By year’s end, Venezuela’s economy will have shrunk by nearly a third in the past four years—a plunge similar to Cuba’s after the fall of the Soviet Union, and one rarely seen outside of conflict zones. In a nation estimated to be sitting on as much oil as Saudi Arabia, inflation was estimated by the International Monetary Fund at 720% this year; and it is expected to surpass 2,000% next year. Shortages are so acute that three out of four Venezuelans lost an average of 18 pounds last year, according to a survey by Venezuelan universities. Diseases not seen there in decades, such as malaria, are back.
Story highlights
- Women and children flock to Colombian border in desperate need of medical care
- Three women describe what it's like to seek help at the border
For the last two years Norma Camero Reno has been shipping a steady supply of desperately needed medicines from the United States to Venezuela. Reno and other members of her nonprofit, Move Foundation, pack painkillers, cold medicines and other supplies to be distributed to hospitals, health clinics and churches throughout the beleaguered nation.
Two weeks ago, however, that all changed.
Reno, a Venezuelan-born, Tampa-based lawyer and founder of the foundation, said that for years her organization faced very little pushback from the government of Venezuelan President Nicolás Maduro when sending packages of food and medicine to the country. But when she arrived in the small, Venezuelan coastal city of Barcelona two weeks ago, Reno discovered that none of the recent medicine shipments had made it to her contacts in the country.
While the group has in the past had to deal with Venezuelan officials confiscating food shipments, this was the first time that medicine has been stopped from being delivered.
“They are stopping everything from going in,” Reno told Fox News. “They are taking everything for themselves.”
Venezuelans have struggled in recent years to get their hands on all types of medical supplies – from over-the-counter painkillers to infection-fighting antibiotics – as the country grapples with widespread shortages and soaring inflation rates brought on by economic mismanagement from the socialist government in Caracas. The lack of equipment like respirators has become so dire that babies are dying in maternity wards from commonplace infirmities that are now considered life-threatening.
Social media has erupted with pleas from many Venezuelans for groups to send prescription medicines to fight illnesses from diabetes to cancer.
For the last two years Norma Camero Reno has been shipping a steady supply of desperately needed medicines from the United States to Venezuela. Reno and other members of her nonprofit, Move Foundation, pack painkillers, cold medicines and other supplies to be distributed to hospitals, health clinics and churches throughout the beleaguered nation.
Two weeks ago, however, that all changed.
Reno, a Venezuelan-born, Tampa-based lawyer and founder of the foundation, said that for years her organization faced very little pushback from the government of Venezuelan President Nicolás Maduro when sending packages of food and medicine to the country. But when she arrived in the small, Venezuelan coastal city of Barcelona two weeks ago, Reno discovered that none of the recent medicine shipments had made it to her contacts in the country.
While the group has in the past had to deal with Venezuelan officials confiscating food shipments, this was the first time that medicine has been stopped from being delivered.
“They are stopping everything from going in,” Reno told Fox News. “They are taking everything for themselves.”
Venezuela’s multi-year economic crisis produces grim stories of scarcity and suffering month after month. Still, new data capturing the woes of the once well-heeled South American nation is shocking: According to new results from an annual national survey, nearly three-quarters of respondents reported losing an average of 19 pounds between 2015 and 2016.
That’s one of a number of astonishing findings from the country’s National Survey of Living Condition, which is conducted by three major Venezuelan universities and other research groups. The survey also found that the portion of respondents who said they ate two or fewer meals increased threefold, climbing from 11.3 percent in 2015 to 32.5 percent in the past year — around 9.6 million people in a country of roughly 30 million are eating at this rate.
Venezuela has been unable to pull out of an economic tailspin that began in 2014, after oil prices around the world plunged. Combined with the government’s shortsighted fiscal policy and overreliance on imports that it can’t afford to keep up, the economy has ground to a halt.
Inflation is skyrocketing — the International Monetary Fund estimates that the country’s inflation is expected to rise 1,660 percent this year and 2,880 percent next year. Shortages of food, medicine, and many basic items abound in what was once the richest country in South America per capita in the 20th century. Malaria is ravaging a country that was the first in the world to eliminate the disease in its populated areas.
Now there’s evidence that the economic chaos is translating into a malnutrition crisis, with people increasingly struggling to secure food as they wait desperately for the economy to recover.
CARACAS, Venezuela — Maikol Mendoza shivered under his flannel blanket, pulling it tightly around him, despite the stuffy, humid conditions in the corridors of Dr. José Manuel de los Ríos Children’s Hospital in Caracas.
A nurse pushed his wheelchair from an emergency dialysis session back to the ICU, wheeling him past bare, peeling blue walls and a bank of broken elevators. When Maikol’s aunt squeezed his shoulder along the way, he reached up, hooked his arm around her neck and pulled her closer.
“I thought I was going to die,” he whispered in her ear, their faces wet with his tears.
Just a week earlier, on Holy Friday, he had been certain of precisely the opposite: In the midst of Venezuela’s dire health crisis, Maikol had been given a new, healthy kidney.
For the first time in two years, the soft-spoken, husky teenager had started making plans. He would finally have the energy to go back to catechism classes, join his neighbor’s foosball games, and plan his 17th birthday celebration.
But then everything went wrong.
Maikol’s relatives could not hunt down all the medicines he needed amid the country's rapidly growing medical shortage, including post-op anti-inflammatory drugs. The hospital ran out of protein-rich food. There were no ambulances available to transfer Maikol to a different facility to get a sonogram done that would evaluate for any complications. When one was finally assigned to him, an anti-government demonstration made it impossible to get there.
Then, Maikol became infected with a highly resistant bacteria borne out of the hospital’s poorly maintained water pipes.
Before he could make sense of what was happening, Maikol, the last transplant patient at the hospital in this dying nation, had to be rushed back to the operating room to remove his new kidney.
“We’re not dogs,” Taina Rodríguez, Maikol’s mother, said angrily. Doctors had told her to prepare for the worst after the transplanted organ began to fail. Rodriguez recently quit her job packaging Doritos to sit by Maikol’s bed in a vigil while the rest of his family has taken turns to visit from Barquisimeto, their hometown, 230 miles west of Caracas.
This left Maikol back at square one, or worse. His life had been snatched from him again, and now his family was left full of uncertainty once more: Would he survive the second surgery? Would they ever find another donor?
Stories like Maikol's are everywhere in Venezuela, where the health care system is on the brink of total collapse and patients who thought they were in the clear are back to fighting a harsh reality. Hospitals have left patients’ families to fend for themselves, scurrying to purchase everything from syringes to anesthesia, often at exuberant black market rates, and forcing doctors to perform surgery with antiquated equipment in operating rooms cleaned with dirty water.
The Health Ministry’s first set of data since July 2015, published earlier this month, should come as no surprise: infant and maternal mortality rose 30% and 65% last year, respectively. The statistics show the country has come a long way from the 1950s to 80s, when Venezuela's vast oil reserves made it one of the wealthiest countries in the region.
The Dr. Jose Manuel de los Rios Children’s Hospital, the gem of Venezuela’s public pediatric care, is a prime example of the health care system’s widespread failure. A report conducted last year by the Universidad Simón Bolívar warned that the hospital’s water tanks had an infestation of rodents and that both the ER and ICU were contaminated by sewage water. It also revealed that in 2015, the hospital received the equivalent of just $39,560 from the federal government for everything from medicine to equipment repair, down from $2.7 million in 2011 (the authors used the parallel, or black market, dollar rate, which has skyrocketed because of currency controls and inflation).
Doctors at the hospital had heard that immunosuppressants, the drugs needed to prevent patients like Maikol from rejecting transplanted organs, were no longer available in the country, but the Health Ministry had yet to make an official announcement.
“There was no way to know if we could really accept the transplant,” admitted Belen Arteaga, the head of the nephrology department at the children’s hospital. “There’s real misinformation.”
On Friday, over one month after Maikol underwent the first surgery, the government office in charge of transplants, Fundavene, sent a letter to Arteaga announcing that it was suspending kidney transplants from deceased people until further notice.
If the health system is on the brink of collapse it's because Venezuela is systematically and rapidly falling apart. Inflation is expected to hit 2,000% by next year; shortages of everything from milk to chicken have led to people losing an average of 19 pounds; and homicides have soared in the already-violent country. President Nicolás Maduro, the less-than-charismatic and increasingly autocratic successor of Hugo Chavez, has announced that he is pulling the country out of the Organization of American States and set in motion a rewrite of the constitution. Daily protests have convulsed the country for over two months, during which more than 50 demonstrators have been killed.
In a move that seems extraordinary for a country not at war, opposition leaders have asked Maduro to allow a channel of humanitarian aid from abroad, a request echoed by a bipartisan group of US senators. Maduro, instead, has handed control over the distribution of medicine to the country’s armed forces.
Amid this chaos, it is children like Maikol who are left with no idea what their future will look like. His second chance at life dashed by the failed transplant, he doesn’t know if he’ll get another one.
In any case, doctors told him that he will have to wait at least a year to try again. By then, Maikol will be an adult. “He told the doctors he never wants to come back to this hospital,” his mother said.
Venezuela’s health crisis is spilling over to neighboring Colombia, where the border town of Cucuta is struggling to provide the medical care increasingly unavailable in the socialist country.
As a result, Cucuta’s main hospital has amassed a monumental amount of debt as it helps out the thousands of Venezuelan patients that arrive every year from across the border. A large number of those are women in labor.
VENEZUELA'S HEALTH CRISIS NEARING CATASTROPHE, GOVERNMENT PLEADS FOR HELP
"In the first quarter of 2017, [Erasmo Meoz Hospital] admitted 1,000 Venezuelans. The increasing rate is worrying, as it could come to 4,000 migrants cared for by the end of this year,” said Health Minister Alejandro Gaviria to Bluradio earlier this month.
He said Venezuelan patients have cost Colombia about $1 million the past year.
By law, any patients who arrive at a hospital in Colombia are admitted to the emergency room at no cost — regardless of their nationality.
"In Venezuela they ask you to bring all the medicines [to the hospital where you are going to be admitted] and yet when you go to the pharmacy there is nothing," Miriam Rivera told Univision. Rivera's teen son fractured his left clavicle recently when he fell off his bicycle.
The woman said that in Ureña, where they reside, the plate needed to repair the fracture would have cost about $100, an astronomical amount in a country where the monthly minimum wage is $15.
According to Univision, Meoz Hospital is carrying a debt $1.3 million dollars for the treatment of Venezuelans.
"Resources are being spent that should be available to the rest of the [Colombian] population," said Meoz hospital administrator Soraya Caceres.
The health minister said the government is committing $3.3 million to keep assisting Venezuelans across the nation’s network of hospitals.
VENEZUELAN MILITARY TO TAKE OVER DISTRIBUTION OF MEDICAL SUPPLIES
He noted, however, that they can’t provide the resources for patients with costly diseases or conditions.
"For now, we only provide humanitarian aid,” he said.
The heath crisis in Venezuela runs so deep that medications ranging from simple anti-inflammatory drugs to chemotherapy drugs are out of reach for most people.
Patients wait for months to get a procedure.
Home to the world’s largest oil reserves, Venezuela was for decades an economic leader in the western hemisphere. But in 1999, with the rise to power of late leader Hugo Chávez – whose left-leaning policies endeared him to the poor, but also set up an unsustainable system of state spending – Venezuela’s economy began to creep toward a crisis.
President Nicolas Maduro claims Venezuela has the best healthcare in the world after Cuba
But death rates are soaring and hospitals are filthy as supplies run low and electricity is shut off
The nation is in economic crisis after price of oil - their main monetary reserve - plummeted
Images taken by the New York Times show patients lying on the floor covered in blood and babies dying
In a country where officials face termination for sharing government health statistics, health experts are relying on outside organizations to shed light on the ongoing health crisis in Venezuela.
In its fourth year of a crippling recession, Venezuela is suffering widespread shortages of medicines and basic medical equipment. A leading pharmaceutical association has said that roughly 85 percent of the country’s medicine supplies are running dry.
With widespread food shortages and an inflation rate of more than 700 percent, millions of Venezuelans are struggling to feed themselves and their families.
Catholic charity Caritas Internationalis has been monitoring levels of malnutrition across four states, including the capital Caracas, since October. It found that 11.4 percent of children under 5 are suffering from moderate or severe acute malnutrition. That figure rises to 48 percent when under-5s at risk or already suffering lower levels of malnutrition are included, according to a report released earlier this week.
By World Health Organization standards, Caritas’ findings constitute a crisis that calls for the government to marshal extraordinary aid.
Still, Venezuelan authorities have so far resisted offers of food and aid from abroad.
“Here, for the government, there are no malnourished children,” Livia Machado, a physician and child malnutrition expert, said in a recent interview with the Wall Street Journal. “The reality is this is an epidemic, and everyone should be paying attention to this.”
For the most part, the government appears to be ignoring the health crisis, apart from occasional statements from President Nicolas Maduro. He blames the ongoing medicine shortages on the opposition, which he claims has been hoarding medicines to encourage a coup against him.
His government is limiting the sharing of data that would quantify the scope of the problem.
Which is why it was unusual that earlier this month the Venezuelan Health Ministry released its first report since July 2015. The report painted an alarming picture: a steep rise in infant and maternal mortality rates and a sharp rise in illnesses such as diphtheria, Zika and malaria.
That reporting came at a cost. Just a few days later, the government announced it was sacking Antonieta Caporale, a gynecologist who held the post of health minister for four months. Vice President Tareck El Aissami announced the move on Twitterwithout citing a reason for the firing.
With no government statistics available, the task of gathering and releasing data on malnutrition has been picked up by doctors, hospitals, individual health experts, international NGOs and Catholic charities.
“We are extremely worried, which is why we are going public with this series of reports,” Caritas country director Janeth Márquez said in a statement.
“Our results clearly show that general levels of malnutrition are rising and acute malnutrition in children has crossed the crisis threshold,” she added. “If we don’t respond soon, it will become very difficult for these children ever to get back onto their nutritional growth curve.”
Caritas has been distributing medicines and food kits to fight malnutrition across the country, but says the efforts of in-country actors are insufficient when considering the scope of the crisis. The report shows one in 12 households were eating leftover food from restaurants and rubbish bins – a dire picture an inflation-crippled economy in which a basic food basket now costs 16 times the minimum wage.
“It’s a major crisis and needs national and international help to manage the scale of the disaster at the highest decision-making levels,” Susana Rafalli, a humanitarian specialist in food emergencies working for Caritas in Venezuela, said in a statement. “Livelihoods have been degraded to such an extent, that the very poor have no means to cope – everything has broken down.”
“Jobs, health care, the family, home – poor people have lost everything as they move about in search of a lifeline,” she added. “The humanitarian community and the people of Venezuela need to begin a full-scale response now.”
In early May, a report appeared on the Venezuelan Health Ministry’s website that no one had seen in almost two years: a weekly health bulletin. This one, from the last week of 2016, had government statistics showing dramatic increases in infant and maternal deaths from the prior year. Two days after the news of the report hit local press, Venezuelan President Nicolás Maduro fired the health minister. Along with the attorney general, who spoke out against government in late March, the women are two of the highest-ranking chavista officials to publicly deny the party line in recent monthsas widespread protests persist.
Assuming a constant birth rate, the government figures would place the infant death rate at around 19 per 1,000 live births and the maternal one at around 100 per 100,000 live births, the latter of which is roughly twice the rate of Venezuela’s neighbors and more comparable to those found in the poorest countries in South America. Doctors say many of the deaths are due to lack of equipment like incubators and even basic medical supplies such as gauze pads and saline solution.
Venezuela Is Running Short of Everything
But even a steady birth rate is far from a given. On the one hand, contraceptives are nowhere to be found in about 90 percent of pharmacies in a country that already had one of the highest rates of teen pregnancies in Latin America. Those with money can buy a condom on the black market for about 22,500 bolivares—25 times the government-controlled price and a third of a monthly minimum wage amid spiraling inflation.
Getting pregnant brings a whole host of new risks amid shortages, as malnourished women give birth to malnourished babies. The new mothers are then often unable to breastfeed. Just 14 percent of Venezuelans say their diet is “sufficient” these days,with many on a diet high in starches and low in nutrients, putting almost an entire generation at risk of a host of lifelong health complications—heart disease and diabetes in particular.
In fact, women are signing up for sterilization in record numbers. Doctors who estimate they used to consult 1 to 2 women per week about the procedure are now seeing five per day. Many perform the procedure on set days, with up to 40 appointments slots per day, which typically did not get filled. Now all slots are quickly taken, with several clinics reporting waiting lists in the hundreds.
Country’s economic crisis takes heavy toll on public health, with infant death rate up 30%, maternal mortality up 65%, and malaria cases up 76% in 2016
A woman shouts slogans in front of police during a rally of health workers and opposition supporters, amid a shortage of medical supplies. Photograph: Carlos Garcia Rawlins/Reuters
Global development is supported by
Reuters in Caracas
Tuesday 9 May 2017 15.11 EDTLast modified on Thursday 1 June 2017 13.38 EDT
Venezuela’s infant mortality rose 30% last year, maternal mortality shot up 65% and cases of malaria jumped 76%, according to government data, sharp increases reflecting how the country’s deep economic crisis has hammered at citizens’ health.
The statistics, issued on an official website after nearly two years of data silence from President Nicolás Maduro’s leftist government, also showed a jump in illnesses such as diphtheria and Zika. It was not immediately clear when the ministry had posted the data, although local media reported on the statistics on Tuesday.
‘Like doctors in a war’: inside Venezuela’s healthcare crisis
Recession and currency controls in the oil-exporting South American country have slashed both local production and imports of foreign goods, and Venezuelans are facing shortages of everything from rice to vaccines. The opposition has organized weeks of protests against Maduro, accusing him of dictatorial rule and calling for elections.
In the health sector, doctors have emigrated in droves, pharmacy shelves are empty, and patients have to settle for second-rate treatment or none at all. A leading pharmaceutical association has said roughly 85% of medicines are running short.
The health ministry had stopped releasing figures after July 2015, amid a wider data blackout.
Its statistics for 2016 showed infant mortality, or deaths of children aged 0-1, climbed 30.12% to 11,466 cases last year. The report cited neonatal sepsis, pneumonia, respiratory distress syndrome, and prematurity as the main causes.
Hospitals often lack basic equipment such as incubators, and pregnant women are struggling to eat well, including taking folic acid, factors that can affect a baby’s health.
Maternal mortality, or death while pregnant or within 42 days of the end of a pregnancy, was also up, rising 65.79% to 756 deaths, the report said.
The health ministry did not respond to a request for further information. Maduro’s government says a coup-mongering elite is hoarding medicines to stoke unrest.
Diphtheria, a bacterial infection that is fatal in 5-10% of cases and that Venezuelahad controlled in the 1990s, affected 324 people, the data showed – up from no cases the previous year.
Diphtheria was once a major global cause of child death but is now increasingly rare thanks to immunizations, and its return showed how vulnerable the country is to health risks.
'Everyone is catching it': Venezuelans fear the worst as Zika infections rise
Reuters documented the case of a nine-year-old girl, Eliannys Vivas, who died of diphtheria earlier this year after being misdiagnosed with asthma, in part because there were no instruments to examine her throat. She was shuttled around several run-down hospitals.
There were also 240,613 cases of malaria last year, up 76.4% compared with 2015, with most cases of the mosquito-borne disease reported in Bolivar state.
Cases of Zika rose to 59,348 from 71 in 2015, reflecting the spread of the mosquito-borne virus around Latin America last year. There was no data for likely Zika-linked microcephaly, in which babies are born with small heads, although doctors say there have been at least several dozen cases.
Caracas, Venezuela - Luis Alberto Machado can barely sustain a conversation, let alone remember the day he attacked his mother by hitting her over the head with a rock.
The 34-year-old was diagnosed with schizophrenia in his mid-teens. Back then he was still a boy but today his gangly frame towers over his petite 60-year-old mother, Maria Machado, making her an easy target for his violent psychosis.
"We've had to lose the fear and learn to hold him down," explained Luis's 28-year-old sister Maria Ruli. "[He's broken] the fridge, the blender. My mother has no life because of him."
"It's gotten worse because there's a lack of Sinogan," said Maria Machado in reference to a sedative widely used for psychiatric illnesses.
Who is to blame for Venezuela’s economic collapse?
The three family members were sitting in the afternoon heat, the last in a line of patients waiting outside the emergency department of one of Caracas' psychiatric hospitals. Ahead of them a handful of parents and carers also waited, hoping to receive anti-psychotic medication for their patients.
In 2013 Venezuelans had access to 70 types of anti-psychotics; today there are only five, according to Wadalberto Rodriguez, president of the Venezuelan Society of Psychiatry.
"There's a 95 percent shortage of anti-psychotics," said Dr Rodriguez. "It's an extremely complex situation because one anti-depressant cannot cure a variety of depressions."
As is the case with staple foods, many Venezuelans are often forced to turn to the black market to buy medication at exorbitant prices.
"All patients are receiving the same kind of treatment, which means that many of them aren't getting any better and the symptoms then become chronic," explained Rodriguez.
The steep reduction in anti-psychotics in Venezuela is partly a result of the country's financial strife.
According to Rodriguez, President Nicolas Maduro's socialist government has often been unable to pay the foreign companies providing Venezuela with medication.
"As a result [the companies] have stopped dispatching [the drugs]," he said.
The failed Vatican-brokered talks between the government and the opposition saw the latter demand the opening of a humanitarian channel to allow medicine into the country, but that channel never materialised.
As a result, many mental health patients in Venezuela are regressing to a state of psychosis and anguish that cannot easily be treated. And although helplines and counselling groups have become increasingly common, this has not halted the rising suicide rate.
READ MORE: Venezuela - Patients dying as crisis hits hospitals
While there are no accurate figures yet, psychologist Dr Yorelis Acosta is adamant that there has been a stark rise in suicides.
"We're starting to see more information on suicides and keeping count of it," said Acosta. "In the month of January, 32 suicides were registered in Caracas alone. This is an alarming number that should grab the government's attention."
The shortage of drugs, which began in mid-2016, has resulted in a large number of patients being re-admitted into under-equipped hospitals.
"We've more and more patients each day," said 32-year-old nurse Carlos, whose real name has been changed to protect his identity.
Before 2016 the clinic received an average of five emergency cases per day. On the day Al Jazeera visited, they received about 20 during a single afternoon, in addition to those already hospitalised.
"Almost all the patients we have at the moment have been re-admitted because they couldn't find their [prescribed] medicine," explained the nurse, sitting outside the psychiatric hospital he has worked at for eight years. "The last medications we received came through a month ago and before that we hadn't received any in four months."
IN PICTURES: The face of hunger and malnutrition in Venezuela
Despite a surge in people needing to be hospitalised, doctors have been forced to turn away desperate cases owing to lack of food, water, medical equipment and even staff.
Carlos is one of four nurses per 30 patients in a hospital with poor ventilation, and where there is running water for just half an hour each morning and 10 minutes each afternoon.
"The rooms are fetid and sometimes the patients can't shower. People wet themselves and we've no diapers," said Carlos.
"There are 60 [hospitalised] patients at the moment, but we've capacity for 90,. We have had to block places because there are no doctors. They've left," added the young nurse.
Working to take care of the mentally ill has become an ordeal in Venezuela's understaffed hospitals.
With sedatives no longer readily available, physical restraint has become a common practice, which also has its hazards for the staff.
"We've no measures to protect ourselves; a patient with psychosis [can] self-harm, harm other patients and throw the ward into chaos," explained Carlos.
Outside the emergency ward was a young carer with scars inflicted by her unmedicated patient on her forearms. The patient, an elderly woman with spots of dry blood on her earlobes and a mass of dishevelled hair, sat beside her, mumbling unintelligible phrases.
WATCH MORE: Patients going without treatment in Venezuela's public hospitals.
Next to the carer and her patient, an elderly mother clutched a brown folder containing years of medical bills belonging to her schizophrenic son, a pale 62-year-old man with large brown eyes. His mother had spent the past day and a half searching for his medication in several pharmacies to no avail.
Her son was diagnosed with schizophrenia at 28, but he went on to study law and was employed for many years. "He worked in a court with top lawyers, but because of the shortage of medication he became ill again," said Clara, whose real name has been changed to protect her privacy.
Clara explained that she has spent more than $5,000 in healthcare for her son in a year and lost 20kg in the same space of time as a result of the country's dire food shortage.
"Three months ago the situation got worse, he stopped eating and he doesn't go to the toilet any more. He's going to die of malnourishment," she added.
"Either [the government should] give me the medicine or pay me back what they owe me."
That warm February afternoon the mother-of-three had tried to hospitalise her son, but a shortage of staff and medication meant that they were turned away and forced to try other hospitals.
READ MORE: Clinics attacked in Venezuela vote violence
While patients and their dwindling access to drugs is a prime concern in a country where mental health problems are on the rise, family members have also become victims of scarcity, forced to supervise patients in an almost oppressive manner in the hope that they will not slip into psychosis and harm themselves or others. On the way into the emergency ward a leaflet on the door offers counselling sessions to family members.
Nicole plans to attend these meetings to help her cope with her 24-year-old schizophrenic son's bouts of psychosis. "Sometimes I feel like my head is under too much pressure and that my veins might explode," she explained.
Sometimes Nicole - who asked that her real name not be used - spends entire mornings searching for her son's antipsychotic medication instead of working her morning shift.
"I do what I can, I even owe [people] money in order to buy the medicine. Right now I'm searching for one medication, but you never know if you're going to find it, so when he gets down to three or four pills you start to feel anguish and anxiety," explained the 60-year-old mother whose son regularly slips into psychosis, a state that sees him tormented by visual and auditory hallucinations.
"Sometimes I spend one or two days [searching for the medication]. I worry because if I don't work I don't earn," said Nicole, who cares for her son alone.
Patients often halve the the dosage of their medication to make it last longer [Sofia Barbarani/Al Jazeera]
Those who can afford to leave Venezuela have done so in large numbers, travelling to neighbouring countries or to the US. Patricia, a 35-year-old stylist, has plans to migrate soon to find financial stability and a functioning health system for her depression and anxiety attacks.
"The state of the country is affecting me, so I've decided to go to Colombia," explained Patricia, who had been unable to find two of her three prescribed drugs.
One mother, who was also desperately searching for medication for her son, interjected: "They didn't send us an atomic bomb, but they left us without medication - which is the same."
Source: Al Jazeera News