CARACAS, Venezuela — One of the severest power outages in Venezuelan history ravaged the country for a second day Friday, with hospital patients languishing in the dark, most supermarkets closed and phone service largely knocked out in the oil-rich but economically collapsing country.

Venezuela, which has been roiled by a political struggle between President Nicolás Maduro and opposition leader Juan Guaidó, has been hit by outages before. But the blackout that began Thursday evening is the longest and most widespread in recent memory, a sign of the rapid deterioration of the economy, which is expected to contract sharply in the next few weeks as U.S. sanctions on the oil industry begin to bite. Some analysts even worry that the country — once among the richest in South America — could face famine.

Power began to flicker on in Caracas and other parts of the country Friday afternoon. But around the country, most stores and restaurants were closed, and few cars ventured into the streets. The outage also stalled refineries and oil plants, the source of nearly all of Venezuela’s export revenue. NetBlocks, a nongovernmental organization that tracks Internet disruptions around the globe, said the Internet outage was massive in Venezuela; at one point, only 2 percent of the country had connectivity.

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At hospitals Friday, doctors and nurses struggled to help patients in facilities with no light or electricity. At the private Avila clinic in an upper-middle-class neighborhood of Caracas, a generator kept a few areas running, such as the emergency room. 

But Daniela Ruiz, who was 39 weeks pregnant, sat uncertainly on a couch in the reception area. Doctors had planned to induce labor because of a lack of fluid in her womb, the 32-year-old communications consultant said.

“Because of the lack of electricity, nothing is working,” she said. “We can’t communicate with the doctor; the phones don’t work.”

Her husband, Daniel Cisneros, 33, said he had never seen anything like the outage. Asked who was responsible, he said: “For the people here, everything that happens in the country is Maduro’s fault.”

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Maduro blamed the power outage on sabotage by the U.S. government, which has backed Guaidó’s effort to force out the authoritarian leader. Maduro offered no evidence for the claim. He ordered schools and offices closed Friday.

“The power war announced and directed by U.S. imperialism against our people will be defeated,” Maduro tweeted in Spanish late Thursday. 

The state electricity company, Corpoelec, said there had been “sabotage” of the Guri hydroelectric complex in southern Bolívar state — the source of most of the country’s electricity. On Friday evening, state TV reported that security forces and the military were being deployed nationwide to protect the electrical system and to help the population during the blackout.

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Elliott Abrams, the U.S. special envoy for Venezuela, denied any U.S. role in the blackout. 

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The outage “is a reminder that the country’s once quite sophisticated infrastructure has been plundered and allowed to decay under Maduro’s misrule,” he told reporters in Washington.

For years, experts and workers at the state electric company have warned about a crippling lack of maintenance and the massive exodus of professionals from power plants and other institutions. 

Russ Dallen, a Florida-based managing partner at the brokerage Caracas Capital Markets, said the cause of the outage was that the government “stole the money that should have been invested in upgrading the power grid and in buying power plants.” 

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Wealthier neighborhoods awoke Friday to the roar of generators, but even there, the blackout generated chaos. In some buildings, the water stopped flowing as pumps stopped working. With elevators not functioning, neighbors had to carry disabled elderly residents to their apartments on the upper floors of buildings. 

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At the University Hospital of Caracas, which serves a poor clientele, a woman with AIDS who was receiving intravenous nourishment died overnight when a catheter slipped from her arm and no one noticed in the darkness, according to a 27-year-old doctor doing a residency, who spoke on the condition of anonymity because she was not authorized to comment. “The patient’s blood sugar level dropped a lot, and she quickly died as a consequence,” said the resident. 

The nationwide blackout stunned citizens who were already living through a political crisis. Guaidó, the National Assembly speaker and self-declared interim president, has been trying to force out Maduro. Dozens of countries have recognized Guaidó as the legitimate president of Venezuela, maintaining that Maduro won a second term through a fraudulent election. The de facto president accuses the opposition leader of attempting a coup.

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Guaidó, who called for another round of anti-Maduro demonstrations on Saturday, tweeted in Spanish on Friday that the blackout was not the result of foreign sabotage. “Sabotage is corruption, sabotage is not allowing free elections, sabotage is blocking the entry of food and medicine,” he said, referring to the Maduro government’s recent move to block shipments of international humanitarian aid arranged by the opposition. 

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In a series of tweets overnight, Secretary of State Mike Pompeo had ridiculed the Venezuelan government for blaming outsiders for the power outage.

“The power outage and the devastation hurting ordinary Venezuelans is not because of the USA. It’s not because of Colombia. It’s not Ecuador or Brazil, Europe or anywhere else. Power shortages and starvation are the result of the Maduro regime’s incompetence,” he wrote.

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At a public hospital in El Valle, a poorer neighborhood, hallways and operating rooms were dark Friday.

“Our biggest problem today was the lack of staff,” said Victor Siegert, a doctor who is director of the Hugo Chávez Frías Maternity and Children’s Hospital. Many couldn’t arrive because the metro and public transportation were barely operating. 

José Luis Mesa, a 49-year-old electrician whose infant grandson was being treated at the emergency room of the University Hospital, said workers frantically tried to keep the generators working late Thursday.  

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“We saw how the security guards ran all over the place to get diesel,” he said. 

Most supermarkets were closed Friday. One private store in an upscale neighborhood was open — but it was only accepting Venezuelan bolívares. Few people have cash, however, because the government hasn’t been able to print bills fast enough to keep up with an inflation rate soaring toward 10 million percent a year. Most banks limit bolívar withdrawals to the equivalent of about $1 a day.

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Eduardo Domínguez, 45, a graphic designer, wanted to purchase food, but cashiers weren’t accepting his debit card because of the electricity outage.

“They don’t accept dollars. I can’t buy anything,” he said.

Venezuela is heavily dependent on food imports, in part because the government nationalized farms in past years, leading to declining agricultural production. But it has cut back on imported food as it has struggled with high debt and the brutal economic crisis. 

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Many nongovernmental groups worry that recently imposed U.S. sanctions on Venezuelan oil will further reduce the government’s ability to import food, leading to even worse hunger.

Rachelle Krygier in Miami and Carol Morello in Washington contributed to this report. 

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