Even in the capital, only two of nine operating rooms are functioning at the J. M. de los Ríos Children’s Hospital.
“There are people dying for lack of medicine, children dying of malnutrition and others dying because there are no medical personnel,” said Dr. Yamila Battaglini, a surgeon at the hospital.
Yet even among Venezuela’s failing hospitals, Luis Razetti Hospital in Barcelona has become one of the most notorious.
In April, the authorities arrested its director, Aquiles Martínez, and removed him from his post. Local news reports said he was accused of stealing equipment meant for the hospital, including machines to treat people with respiratory illnesses, as well as intravenous solutions and 127 boxes of medicine.
Around 10 one recent night, Dr. Freddy Díaz walked down a hall there that had become an impromptu ward for patients who had no beds. Some clutched blood-soaked bandages and called from the floor for help. One, brought in by the police, was handcuffed to a gurney. In a supply room, cockroaches fled as the door swung open.
Dr. Díaz logged a patient’s medical data on the back of a bank statement someone had thrown in the trash.
“We have run out of paper here,” he said.
On the fourth floor, one of his patients, Rosa Parucho, 68, was one of the few who had managed to get a bed, though the rotting mattress had left her back covered in sores.
But those were the least of her problems: Ms. Parucho, a diabetic, was unable to receive kidney dialysis because the machines were broken. An infection had spread to her feet, which were black that night. She was going into septic shock.
Ms. Parucho needed oxygen, but none was available. Her hands twitched and her eyes rolled into the back of her head.
“The bacteria aren’t dying; they’re growing,” Dr. Díaz said, noting that three of the antibiotics Ms. Parucho needed had been unavailable for months.
He paused. “We will have to remove her feet.”
Three relatives sat reading the Old Testament before an unconscious woman. She had arrived six days before, but because a scanning machine had broken, it was days before anyone discovered the tumor occupying a quarter of her frontal lobe.
Samuel Castillo, 21, arrived in the emergency room needing blood. But supplies had run out. A holiday had been declared by the government to save electricity, and the blood bank took donations only on workdays. Mr. Castillo died that night.
For the past two and a half months, the hospital has not had a way to print X-rays. So patients must use a smartphone to take a picture of their scans and take them to the proper doctor.
“It looks like tuberculosis,” said an emergency room doctor looking at the scan of a lung on a cellphone. “But I can’t tell. The quality is bad.”
Finding medicine is perhaps the hardest challenge.
The pharmacy here has bare shelves because of a shortage of imports, which the government can no longer afford. When patients need treatment, the doctors hand relatives a list of medicines, solutions and other items needed to stabilize the patients or to perform surgery. Loved ones are then sent back the way they came to find black-market sellers who have the goods.
The same applies to just about everything else one might need here.
“You must bring her diapers now,” a nurse told Alejandro Ruiz, whose mother had been taken to the emergency room.
“What else?” he asked, clutching large trash bags he had brought filled with blankets, sheets, pillows and toilet paper.
Nicolás Espinosa sat next to his tiny daughter, who has spent two of her five years with cancer. He was running out of money to pay for her intravenous solutions. Inflation had increased the price by 16 times what he paid a year ago.
He flipped through a list of medicines he was trying to find here in Barcelona and in a neighboring city. Some of the drugs are meant to protect the body during chemotherapy, yet the girl’s treatments ended when the oncology department ran out of the necessary drugs a month and a half ago.
Near him, a handwritten sign read, “We sell antibiotics — negotiable.” A black-market seller’s number was listed.
Biceña Pérez, 36, scanned the halls looking for anyone who would listen to her.
“Can someone help my father?” she asked.
Her father, José Calvo, 61, had contracted Chagas’ disease, a sickness caused by a parasite. But the medication Mr. Calvo had been prescribed ran out in his part of Venezuela that year, and he began to suffer heart failure.
Six hours after Ms. Pérez’s plea, a scream was heard in the emergency room. It was Mr. Calvo’s sister: “My darling, my darling,” she moaned. Mr. Calvo was dead.
His daughter paced the hall alone, not knowing what to do. Her hands covered her face, and then clenched into fists.
“Why did the director of this hospital steal that equipment?” was all she could say. “Tell me whose fault is this?”
The ninth floor of the hospital is the maternity ward, where the seven babies had died the day before. A room at the end of the hall was filled with broken incubators.
The glass on one was smashed. Red, yellow and blue wires dangled from another.
“Don’t use — nonfunctional,” said a sign dated last November.
Dr. Amalia Rodríguez stood in the hallway.
“I had a patient just now who needed artificial respiration, and I had none available,” Dr. Rodríguez said. “A baby. What can we do?”
The day of the power blackout, Dr. Rodríguez said, the hospital staff tried turning on the generator, but it did not work.
Doctors tried everything they could to keep the babies breathing, pumping air by hand until the employees were so exhausted they could barely see straight, she said. How many babies died because of the blackout was impossible to say, given all of the other deficiencies at the hospital.
“What can we do here?” Dr. Rodríguez said. “Every day I pass an incubator that doesn’t heat up, that is cold, that is broken.”