The Washington PostDemocracy Dies in Darkness

In Peru, coronavirus patients who need oxygen resort to black market and its 1,000 percent markups

A neighbor helps César García, left, carry an oxygen tank home to his stepson, Mario Solís Rodríguez, who is bedridden with covid-19 in Lima, Peru. (Rodrigo Abd/AP)

LIMA, Peru — Mario Solís Rodríguez needed oxygen. His mother had no choice.

The creaking public hospitals were overwhelmed with patients. The government’s coronavirus hotline wasn’t responding to her desperate calls. So Denisse Rodríguez resorted to the black market.

Scouring Facebook, the 48-year-old housewife found an informal vendor offering a tank for 4,500 soles — nearly $1,300. The oxygen was of unknown quality, and its price a markup of around 1,000 percent — a crushing blow for a family whose principal breadwinner, Rodríguez’s husband, typically earns less than $50 a day driving a mototaxi, a motorcycle rickshaw, here in the Peruvian capital.

Peru took early, aggressive measures against the coronavirus. It’s still suffering one of Latin America’s largest outbreaks.

But Solís was gasping for air. Rodríguez borrowed the money from family and friends.

“What else were we supposed to do?” she asked, tearing up. “Without the oxygen, my son can’t make it through the night. Even if they took him to hospital, they would just kill him.

“I have no idea how we will pay the money back.”

The family’s plight has become typical in Peru, which has reported more than 240,000 cases of covid-19 and 7,200 deaths. Even before the pandemic struck, the Andean country’s public health-care system was struggling to meet the routine needs of its 31 million citizens after decades of chronic underinvestment. Peru spends less than $700 on health care per person per year, among the lowest rates as a share of gross domestic product in Latin America.

Now, the outbreak has encouraged Peru’s army of forgers — the country is the world’s biggest producer of counterfeit dollar bills — to flood the market with fake or low-quality masks and medicines to treat covid-19.

When The Washington Post contacted the vendor that supplied the oxygen to Rodríguez, the person who answered the phone confirmed that they were selling tanks of eight cubic meters for 4,500 soles, but declined to say where the gas had come from or answer further questions.

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In theory, Peru has universal health care, as decreed last year by President Martín Vizcarra. But as he acknowledged at the time, the announcement was largely aspirational — it would mean nothing without more money and personnel.

Nowhere has the gap between hope and reality been more devastating during the coronavirus outbreak than in the nation’s oxygen supply.

A lack of parts and maintenance means several hospitals’ oxygen plants have been out of service for years. Authorities are still trying to enforce a $6.9 million fine for alleged price-fixing imposed in 2013 on two companies that dominate the supply to public hospitals.

Health Minister Víctor Zamora says Peru now faces a daily shortfall of 180 tons of oxygen. He has unveiled a $28 million package to import oxygen and build new plants, and is calling on the country’s Congress to criminalize hoarding and speculation on medical supplies.

“Until that happens, we don’t have a way to intervene,” he said. “The only tool we have right now is our purchasing power. Only when we buy more and become more effective in distributing this essential medicine are we going to reduce this practice.”

The package’s prospects in Congress are unclear.

Latin America had time to prepare for the coronavirus. It couldn’t stop the inevitable.

The Vizcarra administration’s response to Peru’s outbreak has generally drawn praise. The number of confirmed cases, second in the region only to much larger Brazil’s, is seen as a reflection of a successful testing strategy. Nearly 1.4 million Peruvians have been tested, roughly 4.5 percent of the population, a far higher proportion than in most Latin American nations.

But poverty, corruption, inefficiency and informality have handicapped the government’s handling of both the public health and economic crises. Most analysts agree that the official death toll of 7,257 is a significant undercount.

With new cases averaging around 4,000 per day, officials insist that Peru’s curve is starting to bend downward, and they have begun to reopen the economy.

But for Rodríguez and her family, the daily quest for oxygen continues.

Solís, a 29-year-old worker at a shipping company, fell ill at the end of May, and he has been bedridden ever since in the crowded family home he shares with his mother, stepfather and eight other relatives in the gritty Comas district of Lima.

The family is now buying oxygen from the company of a former sailor, Luis Barsallo, who has not jacked up his prices. He calls his competitors “sicarios” — hit men.

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Refilling the tank has become an all-day affair. Solís’s stepfather, César García, lines up outside Barsallo’s depot at 4 a.m. each day. Around 9 a.m., another relative brings Solís’s emptied tank to García. García continues to wait until his turn to replenish, which comes around 4 p.m. Refilling the tank costs about $26.

García then takes the urgent two-hour taxi ride back to his home, where Solís lies struggling for each breath. The family hopes the oxygen will see him through another 24 hours.

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Coronavirus: What you need to know

Vaccines: The CDC recommends that everyone age 5 and older get an updated covid booster shot designed to target both the original virus and the omicron variant. Here’s some guidance on when you should get the omicron booster and how vaccine efficacy could be affected by your prior infections.

Variants: Instead of a single new Greek letter variant, a group of immune-evading omicron spinoffs are popping up all over the world. Any dominant variant will likely knock out monoclonal antibodies, targeted drugs that can be used as a treatment or to protect immunocompromised people.

Tripledemic: Hospitals are overwhelmed by a combination of respiratory illnesses, staffing shortages and nursing home closures. And experts believe the problem will deteriorate further in coming months. Here’s how to tell the difference between RSV, the flu and covid-19.

Guidance: CDC guidelines have been confusing — if you get covid, here’s how to tell when you’re no longer contagious. We’ve also created a guide to help you decide when to keep wearing face coverings.

Where do things stand? See the latest coronavirus numbers in the U.S. and across the world. In the U.S., pandemic trends have shifted and now White people are more likely to die from covid than Black people. Nearly nine out of 10 covid deaths are people over the age 65.

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