A food line: People can wait for hours—or all day—and still go home with nothing. The economy is in ruins. Full-scale food riots 48 THE NEW YORKER, NOVEMBER 14, 2016 LETTER FROM VENEZUELA A FAILING STATE Food shortages in a land of plenty. BY WILLIAM FINNEGAN sometimes break out. “Rice, pasta, sugar, cooking oil, bread, coffee. We produce these things. Or used to. Now they all require lines.” PHOTOGRAPH BY OSCAR B. CASTILLO he medical student told me Three weeks earlier, he had been am- bullet out if we can. But, either way, to use his name. He said he bushed on his motorbike and shot three the wounds need to be drained.” T didn’t care. “Maduro is a don- times, in the chest and the left arm. Were the police investigating the key,” he said. “An asshole.” He meant “They were going to shoot me again, robbery? Nicolás Maduro, the President of Ven- but one of the malandros”—bad guys— Nestor looked down. The naïveté ezuela. We were passing through the “said I was already dead. They took of the question left it beneath reply. wards of a large public hospital in Va- my motorbike.” Nestor spoke slowly, Venezuela has, by various measures, the lencia, a city of roughly a million peo- his voice uninflected. His skin was world’s highest violent-crime rate. Less ple, a hundred miles west of Caracas. waxy. The wounds to his arm and chest than two per cent of reported crimes The hallways were dim and stifling, were uncovered, half healed, dark with are prosecuted. thick with a frightening stench. Some dried blood. There was a saline drip We had to go, the medical student were full of patients waiting silently in in his right arm and, at the foot of his said. Grace and Nestor thanked us, long lines outside exam rooms. Oth- bed, an improvised contraption, made though we had done nothing for them. ers were dark and deserted, with the from twine and an old one-litre plas- The medical student was worried about overhead lighting ripped out. The med- tic bottle, whose purpose I couldn’t what he called “spies.” He had smug- ical student, lithe and light-haired, kept figure out. gled me into the hospital through a us moving, peering through swinging Did the hospital provide the saline? broken back door. The regular entrances doors, conferring with colleagues in No. Grace brought it. She also to the hospital were all manned by uni- blue scrubs. brought food, water, and, when she formed personnel with rifles—National We ducked into a room stuffed with could find them, bandages, pain med- Guard, mostly, but also police, both rusted bed frames and dirty plastic bar- ication, antibiotics. These things were local and national, and other, less iden- rels, where in a corner a thin young available only on the black market, at tifiable militia. Hospitals in Caracas man was propped on a bed without high prices, and Grace’s job, in a ware- were even more tightly secured. Why sheets. He watched us weakly. A young house, paid less than a dollar a day. were hospitals so heavily guarded? No- woman in a pink T-shirt stood beside “The hospital doesn’t even give body threatened to invade them. The him, rigid with surprise. The medical water,” the medical student said. He guards had orders, it was said, to keep student gently asked if they would an- was watching the hallway. He studied out journalists. Exposés had embar- swer my questions. The young man Nestor briefly. “The lungs fill with liq- rassed the government. nodded. His name was Nestor. He was uid after someone is shot in the tho- Most of the elevators were out of twenty-one. This was his wife, Grace. rax,” he told me. “We usually take the order, so we took the stairs. At night, the medical student said, these stair- wells were dangerous—unlit and prowled by muggers. But how could muggers get past the guards? “They work together,” he said. “They share.” He took me down a grimy corridor to a heavy door, which he cracked open. Beyond it, I could see a gleam- ing, brightly lit hallway with freshly painted light-blue walls and a pol- ished white tile floor. “This is the area they show visitors,” he whispered. He peered at me to make sure I under- stood. Got it: Potemkin General. We hurried away. I was introduced to a surgeon, who took me outside to speak. We stood under a tin roof, near piles of garbage and a deserted loading dock. The sur- geon was bearded, heavyset, nervous. He looked exhausted. He did not want me to know his name, let alone use it. “We have no basic trauma tools,” he said. “Sutures, gloves, pins, plates.” He ran down a list of unavailable medi- cations, including ciprofloxacin, an all-purpose antibiotic, and clindamy- cin, a cheap antibiotic. The doctors lost surgical patients because they had no adrenaline. They could still do some survive.” He asked the man, whose she was out here. She was looking types of blood tests, but they could no name was José, about blood tests. after her mother, who was in the hos- longer test for hepatitis or H.I.V./AIDS. José said that he had raised the forty pital. The young woman taught pri- The electricity supply was a problem. dollars for the tests, partly by beg- mary school, and her students came At one stage, the operating room had ging on buses, after losing his job. to school hungry, and she had some been closed for a week. The waiting list Now he needed money for medicines, choice things to say about President for surgery was now three months. In none of which the pharmacies had in Maduro. Use my name, she said. She Maracaibo, a major city farther west, stock. “We must buy from the mafia,” wasn’t afraid. But I didn’t want to surgeons had been reduced to operat- he said. He meant the black market, put more than her first name in my ing by cell-phone flashlight. but not just the ubiquitous notes. If guards or the col- The surgeon headed back inside. profiteers known as bacha- ectivos saw my notebooks, Doctors had been fired, I knew, for queros. The medical stu- they might be seized. talking to reporters, even for simply dent understood. Some of filing complaints about hospital con- the security forces that he revolution being ditions. The government did not want were deployed, or self- T defended is usually to know. There were private clinics to deployed, to the hospital known, in Venezuela, as which high officials and Venezuelans were in the medical-supply Chavismo, for its chief pro- with dollars took themselves and business. tagonist, Hugo Chávez, their families. Those who could went The overstaffed en- who was the country’s Pres- abroad. trances—all the military ident from 1999 until his “I’ve seen public hospitals in Chile and police uniforms and firepower— death, in 2013. For decades, the coun- and Argentina,” the medical student began to make more sense. Cops and try had been ruled by two centrist par- said. “They’re clean, fine, efficient, like soldiers, militares, were notoriously ties that took turns winning elections they used to be here. We’re going back- underpaid. There was money to be but were increasingly out of touch with ward. All because of this government!” made here. We talked to other fami- voters. A move to impose fiscal auster- Public health in Venezuela is, in fact, lies camped on the walkway, and on ity was rejected, in 1989, with a mass getting rapidly worse. In 1961, Vene- concrete benches under an awning revolt and countrywide looting—a par- zuela was the first country declared free closer to the hospital buildings. Some oxysm known as the Caracazo—which of malaria. Now its robust malaria- people were surprisingly outspoken. was put down by the Army at a cost of prevention program has collapsed, and They denounced the prices charged hundreds, perhaps thousands, of lives. there are more than a hundred thou- for examinations (in a system of sup- Chávez was an Army lieutenant colo- sand cases of malaria yearly. Other dis- posedly free health care), the corrup- nel, from a humble background—his eases and ailments long vanquished tion, the intimidation, the outrageous parents were village schoolteachers. He have also returned—malnutrition, diph- prices for sterile gauze, saline, food crashed the national stage in 1992, by theria, plague. The government releases (when there was food), and medica- leading a military-coup attempt. The few statistics, but it is estimated that tions. Some militares had the nerve to coup failed, and Chávez went to jail, one out of every three patients admit- accuse the families of profiteering, and but his televised declarations of noble ted to a public hospital today dies there. to seize their hard-won supplies when intent caught the imaginations of many State mental hospitals, lacking both they tried to enter the hospital. These Venezuelans. He offered a charismatic food and medications, have been re- were items that, often, they had bought alternative to the corrupt, sclerotic sta- duced to putting emaciated, untreated from other militares, who had looted tus quo. After his release, he headed a patients out on the streets. them from pharmacies, or from ship- small leftist party and easily won the We circled the hospital grounds, fol- ments meant for hospitals. The worst Presidency. lowing a tin-roofed walkway.