CARACAS, Venezuela — In Venezuela, getting sick has never been more deadly.
Medicines from antibiotics to chemotherapy drugs have become increasingly scarce in recent years. Public hospitals ask patients' families to supply bedsheets and syringes. HIV patients have gone months without their drugs, and transplant patients have died without the immunosuppressants they need after surgery.
But the country is now experiencing a crisis in one of the most basic medical necessities: blood.
Lower oil prices and populist policies championed by the late Hugo Chávez and continued by his successor, President Nicolás Maduro, have plunged Venezuela into a spiraling economic emergency. The health system, which is also plagued by mismanagement and corruption, is crumbling.
Late last year, the situation turned so dire that blood for transfusions and surgeries was in critically short in supply at public hospitals. In January and February, medical workers say, the scarcity paralyzed most public blood banks, forcing patients to wait for urgent procedures and prompting doctors to advise families to try to acquire processed blood from private clinics.
The problem, according to doctors, is not so much a lack of donors as a shortage of the seven reagents that test donated blood for infections. Those reagents, which the Health Ministry and the Institute of Social Security import to distribute to public institutions here, are priced in dollars, making them expensive in the local currency, the near-worthless bolívar.
Without the reagents, blood can’t be used.
On a morning in late February, Roselvia Escobar showed up at José Manuel de los Ríos, the public children’s hospital in Caracas, to beg for help finding blood for her 22-year-old son, Cesar, who needs three transfusions a month.
Cesar was diagnosed at birth with thalassemia, a blood disease. If he doesn't get the transfusions, his heart or nervous system could fail and his bones could become deformed. The family was unable to secure blood from December till February, when they got just one unit.
“He’s in bed, drowsy, inactive and terrified,” Escobar, said. “The right to live doesn’t exist in Venezuela. You just pray to God your loved one doesn’t die.”
This week, Venezuelan patients received rare good news — a nearly two-month supply of reagents arrived at most public hospitals, purchased by the Health Ministry and the Institute of Social Security from laboratories and organizations abroad. The Pan American Health Organization said that a separate, donated batch will be sent to the country in the coming weeks and should last an additional month.
But doctors call those deliveries short-term solutions to a long-term problem. Facing uncertainty, many patients' families have resorted to buying processed blood from private clinics, which acquire reagents from laboratories here that import them at black-market dollar rates. The official rate is largely inaccessible to private companies.
Carlos Maldonado, 40, bought blood from a private clinic for his father, who was admitted to Caracas University Hospital after being diagnosed with chronic myeloid leukemia in January. It cost Maldonado nearly two months' worth of wages.
“Thank God we could afford it,” he said. “We all hope he won't need more transfusions.”
But not all private clinics are selling blood. Some reserve their reagents exclusively for their own patients, unless public blood banks call directly and offer other scarce products in exchange for them.
In any case, in a country where 87 percent of the population lives below the poverty line, most families can’t afford to pay what the clinics charge for usable blood. The Health Ministry and the Institute of Social Security did not respond to a request for comment.
“It’s an unimaginable situation,” said Maribel Melendez, secretary general of the Venezuelan Society of Hematologists, which represents most public blood banks nationwide. At the worst point in the shortages — mid-December to late February — 70 percent of banks had no usable blood, she said.
For some patients forced to wait as their families and doctors scramble to get them a supply, the blood has arrived too late.
In mid-February, a teenager caught in a gunfight died at the Domingo Luciani Hospital in Caracas because no blood was available. Six other patients died in the hospital this year for the same reason, according to a hematologist there who spoke on the condition of anonymity to avoid government reprisals. The hospital had no blood reserves from December to March.
At the internal medicine unit of Caracas University Hospital, four patients have died this year for lack of blood, according to a medical resident there. In February, five patients in critical condition were still waiting for blood.
Carla Tovar was nervously praying as she held her sick daughter’s hand at the children’s hospital in January. Fernanda, 9, frequently needs transfusions following chemotherapy treatment for her acute lymphoblastic leukemia.
A week earlier, Fernanda needed an urgent transfusion but the hospital had no blood. Tovar took her by bus to a private clinic two hours away, where her husband works as a security guard. The clinic offered to do a transfusion for six months’ worth of minimum wage. The couple borrowed from friends and relatives to pay for it.
“If she needs another transfusion,” Tovar said in tears, “we have no money left.”
Four other mothers in the waiting room that day were desperate to find blood for their children.
Doctors later told Tovar that Fernanda did need another transfusion. After five days of begging for a unit at multiple hospitals, a public bank gave Tovar one.
“They said I was lucky,” Tovar said.
“That's how the system takes care of Venezuelans these days,” she said. “It needs to end.”