Story

Waiting for Hope: Venezuela's Crumbling Public Health Infrastructure

July 02, 2019 | Pulitzer Center
By
Flaviana Sandoval
Members of a surgical team prepare a donated kidney to be transplanted into a patient at an operating room in the private hospital Clínica Metropolitana, in Caracas, one of the few health centers that still performs this complex medical procedure. Image by Flaviana Sandoval. Venezuela, 2018.

Members of a surgical team prepare a donated kidney to be transplanted into a patient at an operating room in the private hospital Clínica Metropolitana, in Caracas, one of the few health centers that still performs this complex medical procedure. Image by Flaviana Sandoval. Venezuela, 2018.  

Leading surgeons Pedro Rivas (left) and Carlos Rodríguez (right) perform a kidney transplant at the private hospital Clínica Metropolitana, in Caracas. Image by Flaviana Sandoval. Venezuela, 2018.

Leading surgeons Pedro Rivas (left) and Carlos Rodríguez (right) perform a kidney transplant at the private hospital Clínica Metropolitana, in Caracas. Image by Flaviana Sandoval. Venezuela, 2018.

Carlos Román, a 37-year-old man with dark brown skin and black eyes poses for a photo portrait, wearing a brown shirt. He has been a dialysis patient for six years, after suffering kidney failure in 2012. He was registered in the national waiting list for organ donations, but with the stoppage of the organ procurement system in 2017, he now has no chance of getting a kidney for a transplant that could restore his health.

Carlos Román, 37, has been in dialysis for six years, after suffering kidney failure in 2012. He was registered in the national waiting list for organ donations, but with the stoppage of the organ procurement system in 2017, he now has no chance of getting a kidney for a transplant that could restore his health. Image by Flaviana Sandoval. Venezuela, 2018.

The waiting room at Clinica Riverside, in East Caracas, where Carlos Román receives dialysis three times a week, is a dark room with dim white light and rusty white metal chairs. Family members and visitors are not allowed inside the dialysis unit and must wait outside until the patient's session is finished.

The waiting room at Clinica Riverside, in East Caracas, where Carlos Román receives dialysis three times a week. Family members and visitors are not allowed inside the dialysis unit and must wait outside until the patient's session is finished. Image by Flaviana Sandoval. Venezuela, 2018.

Water tanks installed at the Clinica Riverside's front patio. They store water to be used to keep the dialysis unit functioning in case of running water cuts, which are common in Caracas. Image by Flaviana Sandoval. Venezuela, 2018.

Water tanks installed at the Clinica Riverside's front patio. They store water to be used to keep the dialysis unit functioning in case of running water cuts, which are common in Caracas. Image by Flaviana Sandoval. Venezuela, 2018. 

Doctors lean over the operating table, cauterizing an incision on the patient's abdomen, during a kidney transplant performed at the private hospital Clínica Metropolitana, in Caracas. Image by Flaviana Sandoval. Venezuela, 2018.

Doctors lean over the operating table, cauterizing an incision on the patient's abdomen, during a kidney transplant performed at the private hospital Clínica Metropolitana, in Caracas. Image by Flaviana Sandoval. Venezuela, 2018.

During a transplant, a donated kidney recovers its natural color, as it is implanted into the recipient's body and reconnected to the circulatory system. Image by Flaviana Sandoval. Venezuela, 2018.

During a transplant, a donated kidney recovers its natural color, as it is implanted into the recipient's body and reconnected to the circulatory system. Image by Flaviana Sandoval. Venezuela, 2018. 

The University Hospital of Caracas used to be one of the best health centers in Venezuela. It was the first hospital to ever make a kidney transplant in Caracas in 1968, and its transplant center was one of the country's most active. Now, with severe medicine shortages, lack of trained personnel and decaying infrastructure, the hospital crumbles. The last kidney transplant made at the University Hospital occurred in August 2015 and there has been no activity inside the hospital's transplant center ever since. Image by Flaviana Sandoval. Venezuela, 2018.

The University Hospital of Caracas used to be one of the best health centers in Venezuela. It was the first hospital to ever make a kidney transplant in Caracas in 1968, and its transplant center was one of the country's most active. Now, with severe medicine shortages, lack of trained personnel and decaying infrastructure, the hospital crumbles. The last kidney transplant made at the University Hospital occurred in August 2015 and there has been no activity inside the hospital's transplant center ever since. Image by Flaviana Sandoval. Venezuela, 2018.

The Hospital J.M de los Ríos, in Caracas, has the country's only transplant center specialized for children. Pediatric transplants have been suspended in the hospital since mid-2017, effectively sentencing children to remain in dialysis, while they wait for organ procurement to be reactivated. Image by Flaviana Sandoval. Venezuela, 2018.

The Hospital J.M de los Ríos, in Caracas, has the country's only transplant center specialized for children. Pediatric transplants have been suspended in the hospital since mid-2017, effectively sentencing children to remain in dialysis, while they wait for organ procurement to be reactivated. Image by Flaviana Sandoval. Venezuela, 2018. 

Wearing a brown shirt and a pair of blue jeans, Carlos Román sits down while connected to the dialysis machine at Clinica Riverside, in East Caracas. He receives dialysis three times a week during the morning shift, from 7 a.m. to 11 a.m. Image by Flaviana Sandoval. Venezuela, 2018.

Carlos Román sits down while connected to the dialysis machine for his 4-hour-treatment session at Clinica Riverside, in East Caracas, on July 11. He receives dialysis three times a week during the morning shift, from 7 a.m. to 11 a.m. Image by Flaviana Sandoval. Venezuela, 2018.

Carlos Román shows his left brown-skinned arm, scarred with marks of the needles used to connect him to the dialysis machine. A bigger scar is the result of an ambulatory surgery commonly done to dialysis patients to create an AV fistula: a wide, strong blood vessel that connects an artery to a vein, allowing blood to flow out to and return from the dialysis machine. Image by Flaviana Sandoval. Venezuela, 2018.

Carlos Román shows his left arm, scarred with marks of the needles used to connect him to the dialysis machine. A bigger scar is the result of an ambulatory surgery commonly done to dialysis patients to create an AV fistula: a wide, strong blood vessel that connects an artery to a vein, allowing blood to flow out to and return from the dialysis machine. Image by Flaviana Sandoval. Venezuela, 2018.

A display of Carlos Román's medication. Patients in dialysis must carefully follow their treatment, but severe medicine shortages that have affected the country in recent years have made it harder. Patients often must look through several drugstores, resort to social media, or swap medicine for food and other goods. Some even find themselves forced to take expired medication. A solution of vitamin B complex (right) that Roman takes for his treatment expired in May 2018, but he continued to use it through July. Image by Flaviana Sandoval. Venezuela, 2018.

A display of Carlos Román's medication. Patients in dialysis must carefully follow their treatment, but severe medicine shortages that have affected the country in recent years have made it harder. Patients often must look through several drugstores, resort to social media, or swap medicine for food and other goods. Some even find themselves forced to take expired medication. A solution of vitamin B complex (right) that Roman takes for his treatment expired in May 2018, but he continued to use it through July. Image by Flaviana Sandoval. Venezuela, 2018.

Carlos Román sits at his job post, his eyes staring down, wearing a bright royal blue uniform shirt. He works as a cashier in a parking lot at a shopping mall. He works the afternoon shift, from 2 p.m. to 7 p.m. It usually takes several hours to get back home to the satellite city of Guarenas because of the lack of public transportation. Image by Flaviana Sandoval. Venezuela, 2018.

Carlos Román at his job in a parking lot at a shopping mall in East Caracas, where he works as a cashier. He works the afternoon shift, from 2 p.m. to 7 p.m. It usually takes several hours to get back home to the satellite city of Guarenas because of the lack of public transportation. Image by Flaviana Sandoval. Venezuela, 2018.

Organ transplants in Venezuela have become a luxury that the majority of patients cannot afford.

Severe medicine shortages and crumbling public health infrastructure have led to the shutdown of transplant centers all across the country, limiting access to this treatment option that is now only offered at private hospitals for a high price. The government-managed organ procurement system that facilitated organ donations for transplant patients stopped working in 2017, stripping thousands of patients of their hope of ever getting to the operating room.

Those who do not receive transplants are sentenced to the dialysis unit where many endure poor conditions, lack of treatment, and malnutrition. They face chronic illness and even death under a system that has failed to protect their most fundamental right: the right to live.