Leaning against a hospital wall for balance, Elena Suazo wiggled each foot into blue protective pants. Then she slipped her arms into a surgical gown and snapped on white rubber gloves, finally ready to enter the COVID-19 wing.
Suazo is not a nurse. She is a cafeteria worker at a kindergarten in Venezuela’s capital.
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Leaning against a hospital wall for balance, Elena Suazo wiggled each foot into blue protective pants. Then she slipped her arms into a surgical gown and snapped on white rubber gloves, finally ready to enter the COVID-19 wing.
“You do everything you can in the name of love,” said Suazo, 47. “If that person is your blood relative, you don’t even hesitate.”
Relatives of elderly and weak patients are allowed short visits up to three times daily and are responsible for providing their own protective clothing.
This kind of thing has long been common in poor nations, places like South Sudan and Democratic Republic of Congo in sub-Saharan Africa, health experts say. But it's only now come to Venezuela, which was once a wealthy nation, sitting atop the world’s largest oil reserves.
Care is augmented by nearly 2,000 specialists sent by socialist ally Cuba to help battle the pandemic, and by several thousand less-skilled Cuban doctors who already were here. But it’s not enough.
“We’re living a kind of pandemonium,” she said. “Our salary isn’t even enough to cover the cost of public transportation to simply get to work at the hospitals.”
There are other reasons to leave. Dr. Ramfis Nieto-Martinez, 54, said he uprooted his family from Venezuela six years ago, walking away from a thriving practice after six armed men invaded the family’s home and held one of his two teenage sons for ransom. Three years later, the boys were playing soccer near their home when they witnessed a motorcycle robbery in which a man was shot dead.
A retired foreman at a clothing factory, with a big personality and undying love for his six children and 19 grandchildren, Gavino Suazo fell at home one night two years ago and hit his head. Despite a string of surgeries, he never regained speech and has been homebound.
Next, she needed protective gear. She had no money -- as a cafeteria worker, Suazo earns a monthly wage of less than $2 -- so her younger brother bought her one suit. Her son’s mother-in-law gave her a second, so she could go to the hospital twice a day.
At the hospital, Suazo takes a seat on a bench outside with others waiting for security guards to call her name for her turn to go inside. They share stories while waiting, some sitting outside all day.
But family members say the overworked hospital staffers keep the COVID-19 wing clean. The doctors and nurses are kind, they say, but there are simply too few of them. Three or four nurses typically work in the wing with 31 beds for coronavirus patients, and workers said that the same number of doctors oversee this wing and other emergency visits.
“You feel bad and want to help them,” she said. “With the little time I’m given inside, I can’t help everybody.”
The outfit she was wearing on this day also was threadbare. “I’m afraid to go inside,” she said. “I’m having trouble breathing. Maybe it’s just my nerves.”
Officials in Venezuela report roughly 800 deaths from coronavirus among more than 90,000 cases throughout the country. That’s likely a gross undercount, as many fearful of the broken health care system choose rather to stay home.
“In some hospitals authorities have tried to get doctors or the medical teams, nurses, to use and reuse what’s already been used,” said Natera, president of Federation of Venezuelan Doctors.
Dr. Wilfredo Sifontes, who oversees the hospital’s emergency services including its coronavirus wing, described having a fever, cough and feeling sick. Though he oversees testing kits, he himself was never tested and continued to clock in. He dismissed the threat of the coronavirus, comparing it to a “common flu” that’s sparked needless panic.
The wing is staffed with 120 doctors, nurses and technicians who care for 36 patients, including six in intensive care connected to respirators and under sedation.
José Gregorio Hernández Hospital was pretty much the only option for Gavino Suazo. And his daughter’s care made his stay tolerable.
But she is also a loving daughter; her 76-year-old father, sick with the virus, waited inside. And in this ruined country, the only way to ensure that he received the care he needed was to do it herself -- regardless of the dangers to her own health.
With their mop on the floor, two cleaning workers in white biosecurity suits take a break from cleaning the COVID-19 wing next to a security worker in blue scrubs at the entrance to the COVID-wing at José Gregorio Hernández Hospital in the Catia neighborhood of Caracas, Venezuela, Wednesday, Sept 16, 2020. An alarming 231 Venezuelan doctors, nurses and other health care workers have died of the coronavirus nationwide, reported United Doctors of Venezuela, a non-governmental group that lobbies for adequate medical supplies and labor conditions. (AP PhotoAriana Cubillos)
“You do everything you can in the name of love,” said Suazo, 47. “If that person is your blood relative, you don’t even hesitate.”
Hospitals across the once wealthy South American nation lack enough doctors and nurses to confront the coronavirus pandemic. As thousands of trained health care workers emigrated in recent years, some hospital wings have closed. Others keep operating, but with high caseloads.
The shortage leaves families rushing to fill the void at facilities that treat the poor, like José Gregorio Hernández Hospital, which sits in the middle of a sweeping Caracas barrio. They feed patients, bathe them and change their bedsheets -- tasks normally done by trained medical professionals.
Gavino Suazo waits in a wheelchair to be admitted to the COVID–19 wing at José Gregorio Hernández Hospital, a public hospital where doctors diagnosed him with a lung infection in the Catia neighborhood of Caracas, Venezuela, Monday, Sept. 21, 2020. The 76-year-old retired foreman at a clothing factory with six children and 19 grandchildren fell two years ago and hit his head, never regaining his speech and has been homebound despite surgeries. He was discharged after nearly two weeks at the hospital, where his daughter entered daily to feed and bathe him amid a shortage of health workers. (AP PhotoAriana Cubillos)
Relatives of elderly and weak patients are allowed short visits up to three times daily and are responsible for providing their own protective clothing.
Suazo finished dressing at a table near the COVID-19 entrance and looked over to a security guard. He gave her a nod of approval. Suazo tucked her bags of hot chicken soup, fresh bedsheets and cleaning supplies under her arm and ducked past the heavy sliding gate.
“I take care of him quickly, changing his clothes, feeding him, and then I leave,” Suazo said. “You can’t stay inside there long.”
Dr. Wilfredo Sifontes, right, speaks to families who have family hospitalized in the COVID-19 wing, outside José Gregorio Hernández Hospital in the Catia neighborhood of Caracas, Venezuela, Friday, Sept 4, 2020. Sifontes, who oversees the hospital’s emergency services including its coronavirus wing, described having a fever, cough and feeling sick. Though he oversees testing kits, he himself was never tested and continued to clock in. He dismissed the threat of the coronavirus, comparing it to a “common flu” that’s sparked needless panic. (AP PhotoAriana Cubillos)
This kind of thing has long been common in poor nations, places like South Sudan and Democratic Republic of Congo in sub-Saharan Africa, health experts say. But it's only now come to Venezuela, which was once a wealthy nation, sitting atop the world’s largest oil reserves.
Critics blame 20 years of a socialist revolution launched by the late President Hugo Chávez for destroying oil production, leading to an unrelenting economic crisis. A recent round of financial sanctions exacted by Washington against President Nicolás Maduro has made life even harder.
In recent years, an estimated 5 million Venezuelans have fled the nation of 30 million. Among them are roughly 33,000 doctors -- 30% of Venezuela’s physicians, according to Dr. Douglas León Natera, president of the Federation of Venezuelan Doctors.
One of Elena's Suazo's two medical gowns hangs to dry at her parents' home in the Catia neighborhood of Caracas, Venezuela, Tuesday, Sept. 29, 2020, in between her twice-daily trips to care for her hospitalized father in the COVID-19 wing of the public, Jose Gregorio Hernandez hospital. On a cafeteria worker's monthly salary of less than $ , Suazo had no money to buy the needed protective gear, so her younger brother bought her one suit and her son’s mother-in-law gave her a second, allowing her to attend him inside the hospital twice a day. (AP PhotoAriana Cubillos)
Care is augmented by nearly 2,000 specialists sent by socialist ally Cuba to help battle the pandemic, and by several thousand less-skilled Cuban doctors who already were here. But it’s not enough.
At least 6,000 nurses also abandoned Venezuela, said Ana Rosario Contreras, president of the Caracas Nurses College, citing a 2018 survey by the organization. The number has only grown since, she said.
Contreras said it’s common to see one nurse responsible for up to 60 patients — an impossible task. International standards call for one nurse for five or six patients.
Elena Suazo carries the hospital sheets she replaced for her father, and the protective medical gear she wore to attend him at José Gregorio Hernández Hospital as she walks home in the Catia neighborhood of Caracas, Venezuela, Monday, Sept. 29, 2020. A shortage of doctors and nurses leaves families rushing to fill the void at facilities that treat the poor, to feed them, bathe them and change their bedsheets. (AP PhotoAriana Cubillos)
“We’re living a kind of pandemonium,” she said. “Our salary isn’t even enough to cover the cost of public transportation to simply get to work at the hospitals.”
Health care workers interviewed by The Associated Press said doctors at public hospitals earn less than $12 a month, and nurses bring home roughly $6. Working the night shift brings a little more.
While some find additional work in upscale private clinics, one nurse said she sells auto parts on the side to support her three children. A young doctor who sells cakes when not tending to patients said she’s weighing a move for her family to Chile, where she’s confident she’ll find a job that pays an amount commensurate to her years of training.
Elena Suazo, 47, eats lunch at her parent's home before walking to José Gregorio Hernández Hospital, a public hospital where she will feed and care for her father who is hospitalized for COVID0-19, in the Catia neighborhood of Caracas, Venezuela, Tuesday, Sept. 29, 2020. Suazo and her mother cook the food she brings her father twice a day, a 20-minute walk over steep roads that she says has taken its toll, making her a little skinnier, she said. (AP PhotoAriana Cubillos)
There are other reasons to leave. Dr. Ramfis Nieto-Martinez, 54, said he uprooted his family from Venezuela six years ago, walking away from a thriving practice after six armed men invaded the family’s home and held one of his two teenage sons for ransom. Three years later, the boys were playing soccer near their home when they witnessed a motorcycle robbery in which a man was shot dead.
“My wife told me ‘No more,’” said Nieto-Martinez. He now works in Memphis, Tennessee, but dreams daily of returning once life in Venezuela is restored to normal.
Suazo says how her father contracted the coronavirus is a mystery.
Elena Suazo hand washes the protective medical clothing she wears when she attends her father who is hospitalized with COVID-19, in the bathroom at her parent's home before hang drying them, in the Catia neighborhood of Caracas, Venezuela, Tuesday, Sept. 29, 2020. On a cafeteria worker's monthly salary of less than $ , Suazo had no money to buy the needed protective gear, so her younger brother bought her one suit and her son’s mother-in-law gave her a second, allowing her to attend him inside the hospital twice a day. (AP PhotoAriana Cubillos)
A retired foreman at a clothing factory, with a big personality and undying love for his six children and 19 grandchildren, Gavino Suazo fell at home one night two years ago and hit his head. Despite a string of surgeries, he never regained speech and has been homebound.
Then, recently, his temperature soared and his body started to tremble. Doctors diagnosed a lung infection and sent him to the COVID-19 wing at José Gregorio Hernández Hospital.
Elena Suazo moved back to her parents’ home in the hills above the hospital to help out. Her father was too weak to sit up straight in a wheelchair when he entered the hospital; Suazo immediately sought and received approval from the hospital to care for him.
Photographed through a door from outside the José Gregorio Hernández Hospital, Mirley Avila feeds her father Miguel Avila inside the COVID-19 wing in the Catia neighborhood of Caracas, Venezuela, Saturday, Oct. 10, 2020, on a day when there weren't enough nurses so they let her in to feed him, change his sheets and undergarments. According to Caracas Nurses College President Ana Rosario Contreras, a 2018 survey by the organization found that at least 6,000 nurses have abandoned Venezuela and that the number has grown since. (AP PhotoAriana Cubillos)
Next, she needed protective gear. She had no money -- as a cafeteria worker, Suazo earns a monthly wage of less than $2 -- so her younger brother bought her one suit. Her son’s mother-in-law gave her a second, so she could go to the hospital twice a day.
At first, she had nothing to cover her feet, so she used a discarded surgical gown to sew booties to go over her sandals. Suazo hand washes the clothing and hangs each item to dry on a patio clothesline.
She and her mother cook the chicken she brings her father. Then Suazo sets out on a 20-minute walk over steep, winding roads, a twice-daily trek that she says has taken its toll. “I’ve gotten a little skinnier for walking so much,” said Suazo, who is shy and speaks softly.
Venezuelan health workers with Doctors Without Borders attend COVID-19 patients at the Peréz de León II Hospital, a public hospital in the Petare neighborhood of Caracas, Venezuela, Monday, Sept. 22, 2020. The wing is staffed with 120 doctors, nurses and technicians who care for 36 patients, including six in intensive care connected to respirators and under sedation. (AP PhotoAriana Cubillos)
At the hospital, Suazo takes a seat on a bench outside with others waiting for security guards to call her name for her turn to go inside. They share stories while waiting, some sitting outside all day.
Venezuela’s decline has left its mark on José Gregorio Hernández Hospital, a 47-year-old, nine-story building of exposed concrete. The paint is peeling and the elevators often fail. Garbage piles up outside and a pack of dogs roam the grounds. Just a couple hundred beds remain in use.
Hospital administrators denied requests by The Associated Press to enter.
Bags and tubes for oxygen hang outside to dry after being decontaminated at Peréz de León II Hospital, a public hospital in the Petare neighborhood of Caracas, Venezuela, Monday, Sept. 22, 2020. It’s a state hospital that offers free COVID-19 care under the auspices of the international humanitarian group Doctors Without Borders in agreement with Venezuela’s Health Ministry. (AP PhotoAriana Cubillos)
But family members say the overworked hospital staffers keep the COVID-19 wing clean. The doctors and nurses are kind, they say, but there are simply too few of them. Three or four nurses typically work in the wing with 31 beds for coronavirus patients, and workers said that the same number of doctors oversee this wing and other emergency visits.
Throughout the day, relatives deliver food; security guards posted at a desk on the street take it inside to patients. Relatives of the weakest patients dress in protective gear to care for them.
After a visit with her grandmother, Yessenia Suriel, a 30-year-old secretary, peels off a white full-body, biohazard suit, revealing jeans and a white shirt soaked with sweat. Many patients in her grandmother’s wing don’t have anyone to bring food or bathe them, Suriel said.
Nancy Rodriguez, a 76-yar-old COVID-19 patient, wipes tears as she explains her battle with the virus under a tent for patients who will be discharged from the Peréz de León II Hospital, a public hospital where Doctors Without Borders operates in the Petare neighborhood of Caracas, Venezuela, Monday, Sept. 22, 2020. Venezuela's count of roughly 800 COVID-19 deaths among its more than 90,000 cases is likely an undercount, as many are fearful of the broken health care system and choose to stay home. (AP PhotoAriana Cubillos)
“You feel bad and want to help them,” she said. “With the little time I’m given inside, I can’t help everybody.”
Lizmary Moreno, 23, an unemployed waitress, said the risk is worth it to see her 70-year-old grandmother, battling pneumonia, light up when she appears at her bedside. “Ay, my darling, you’ve arrived,” her grandmother says.
One day, hospital officials refused to let her enter because there were holes in her protective gear after repeated washes. Moreno panicked. She pleaded with relatives to help her find a replacement, fearing she’d miss even one visit with her fragile grandmother.
Venezuelan Dr. Jeannette Padrón, the ICU chief with Doctors Without Borders, removes her protective clothing after attending COVID-19 patients at the Peréz de León II Hospital, a public hospital in the Petare neighborhood of Caracas, Venezuela, Monday, Sept. 22, 2020. Staff follows a rigorous protocol for protective clothing and handwashing — with the most attention given to taking off the gear after each shift to avoid contamination. (AP PhotoAriana Cubillos)
The outfit she was wearing on this day also was threadbare. “I’m afraid to go inside,” she said. “I’m having trouble breathing. Maybe it’s just my nerves.”
Relatives going into the COVID-19 wing put themselves at significant risk.
“In an ideal world you wouldn’t want that,” said Dr. Paul B. Spiegel, director of the Center for Humanitarian Health at Johns Hopkins Bloomberg School of Public Health. “If that person’s not going to get food and water or medicine, then what do you do? It’s not unique. It’s just very sad.”
A security worker uses a plastic bag over one of his shoes before going into the COVID-19 wing of the José Gregorio Hernández Hospital, a public hospital in the Catia neighborhood of Caracas, Venezuela, Saturday, Oct. 10, 2020. Two security guards at the COVID-19 entrance say they fought through COVID-19 symptoms, and borrow protective clothing from other hospital workers. (AP PhotoAriana Cubillos)
Officials in Venezuela report roughly 800 deaths from coronavirus among more than 90,000 cases throughout the country. That’s likely a gross undercount, as many fearful of the broken health care system choose rather to stay home.
An alarming 231 Venezuelan doctors, nurses and other health care workers have died of the coronavirus nationwide, reported United Doctors of Venezuela, a non-governmental group that lobbies for adequate medical supplies and labor conditions.
Seven doctors including one nurse died of the virus during one three-day period in October, the group reported. They blame it on a lack of protective supplies.
Davisela Abril, 37, washes her hands after feeding and bathing her father inside the COVID-19 wing of the José Gregorio Hernández Hospital, where the bathrooms didn't have running water on this day, in the Catia neighborhood of Caracas, Venezuela, Sunday, Oct. 4, 2020. Family members of the patients say the doctors and nurses are kind, but that there are simply too few of them. (AP PhotoAriana Cubillos)
“In some hospitals authorities have tried to get doctors or the medical teams, nurses, to use and reuse what’s already been used,” said Natera, president of Federation of Venezuelan Doctors.
Workers at José Gregorio Hernández Hospital say they’ve been spared deaths, though the virus apparently has swept through its staff.
The hospital’s director was quarantined after showing classic symptoms. Three nurses interviewed by the AP said they fell ill, along with several of their relatives. Two security guards at the COVID-19 entrance say they fought through symptoms; they borrow protective clothing from other hospital workers.
Relatives of COVID-19 patients wait outside the COVID-19 wing of the José Gregorio Hernández Hospital in the Catia neighborhood of Caracas, Venezuela, Sunday, Oct 4, 2020. Throughout the day, relatives deliver food and security guards posted at a desk on the street take it inside to patients, while relatives of the weakest patients dress in protective gear to care for them. (AP PhotoAriana Cubillos)
Dr. Wilfredo Sifontes, who oversees the hospital’s emergency services including its coronavirus wing, described having a fever, cough and feeling sick. Though he oversees testing kits, he himself was never tested and continued to clock in. He dismissed the threat of the coronavirus, comparing it to a “common flu” that’s sparked needless panic.
Relatives entering the coronavirus wing he oversees know what they’re getting into, he said. They “are told about the risk to themselves and others,” Sifontes said. “They assume responsibility.”
Standing in sharp contrast is Peréz de León II Hospital, a medical center treating COVID-19 patients in another tough neighborhood of Caracas called Petare. It’s also a state hospital and offers free COVID-19 care but under the auspices of the international humanitarian group Doctors Without Borders in agreement with Venezuela’s Health Ministry.
A security worker lifts the trash lid for Elias Morillo to disregard belongings used by Morillo's relative Maria, 39, who died of respiratory arrest and is suspected of having had the new coronavirus, outside the COVID-19 wing of José Gregorio Hernández Hospital, a public hospital in the Catia neighborhood of Caracas, Venezuela, Saturday, Oct. 3, 2020. Morillo was told that the belongings should be thrown away after they were handed over to him by security workers. (AP PhotoAriana Cubillos)
The wing is staffed with 120 doctors, nurses and technicians who care for 36 patients, including six in intensive care connected to respirators and under sedation.
The rooms have running water and air conditioning. Staff follow a rigorous protocol for protective clothing and handwashing — with the most attention given to taking off the gear after each shift to avoid contamination. Psychologists on staff call to update family members — who are not allowed into the tightly controlled wing.
Hospitals like this one are few in Venezuela. Some private clinics in Caracas operate at international standards. They’re available only to the wealthy, or to patients with insurance willing to pay $2,500 a day or more -- more than 1,250 times the monthly minimum wage that most Venezuelans earn.
A woman who cares for a hospitalized relative removes her protective medical gear after leaving the COVID-19 wing of the José Gregorio Hernández Hospital, a public hospital in the Catia neighborhood of Caracas, Venezuela, Thursday, Sept. 24, 2020. In recent years, an estimated 5 million Venezuelans have fled the nation of 30 million, among them roughly 33,000 doctors, or 30% of Venezuela’s physicians, according to Dr. Douglas León Natera, president of the Federation of Venezuelan Doctors. (AP PhotoAriana Cubillos)
José Gregorio Hernández Hospital was pretty much the only option for Gavino Suazo. And his daughter’s care made his stay tolerable.
Arriving at his bedside, she changed his diaper, gave him a sponge bath and replaced his bedsheet with a pink-and-yellow one she’d brought. She spoon-fed him soup.
“He can’t do these things by himself alone,” she said.
Garbage lays outside the José Gregorio Hernández Hospital, a public hospital in the Catia neighborhood of Caracas, Venezuela, Thursday, Sept. 24, 2020, with the red bag containing what's considered the most contaminated. Venezuela’s decline has left its mark on the public hospital, a 47-year-old, nine-story building of exposed concrete, where just a couple hundred beds remain in use. (AP PhotoAriana Cubillos)
She did the work willingly. “I had the good fortune of having a good mother and a good father,” Suazo said. “They always looked after us.”
After nearly two weeks, doctors told Suazo her father was healthy enough to be discharged. She could arrange for the short car ride up the hill to their home.
As they left the hospital grounds, they passed relatives of those still battling the virus, waited to be let inside.
Follow Scott Smith on Twitter: @ScottSmithAP
Associated Press writer Jorge Rueda contributed to this story.