The earthquakes that struck Venezuela this week exposed the fragility of the country’s emergency medical system after years of economic collapse, institutional decay and mass emigration hollowed out hospitals, ambulance services and rescue operations, according to doctors, emergency responders and humanitarian groups.
In the hardest-hit coastal state of La Guaira, two of the state’s three public hospitals were knocked out of service, leaving the only functioning hospital overwhelmed and out of basic medical supplies, according to Dr. Jaime Lorenzo, the director of a nonprofit, United Doctors of Venezuela.
The hospital is operating without running water, forcing staff to wash their hands and clean bloodstained floors using stored water and intravenous saline, Dr. Lorenzo said.
In Caracas, the roof of one of the city’s main trauma hospitals partly collapsed during the twin quakes on Wednesday. Staff urged patients on social media not to come unless they faced life-threatening emergencies.
The strain extends beyond hospitals. Venezuela has only three functioning public ambulances serving greater Caracas, said Dr. Lorenzo. He estimated that roughly 90 percent of patients from La Guaira arrived in the backs of police pickup trucks following the quakes.
Power outages and telecom failures have further crippled the response. With cellphone networks down, hospitals often receive no advance warning about incoming patients, learning the severity of injuries only when the wounded arrive.
Emergency workers have resorted to radio systems and Starlink satellite internet to communicate after the earthquake disabled much of the commercial cellphone network.
Dr. Lorenzo described firefighters searching collapsed buildings using cellphone lights because of shortages of flashlights. Rescue crews have so few shovels that some have been digging through concrete with their bare hands, he said.
The shortages have forced ordinary citizens to shoulder much of the rescue effort.
Under international urban search-and-rescue protocols, neighbors are considered the first emergency responders before professional rescue teams arrives, said Jacobo Vidarte, an emergency management specialist in Venezuela.
But in Venezuela, volunteers, who sometimes lack training and appropriate equipment, make up roughly 70 percent of those involved in disaster response because the country has so few teams, Mr. Vidarte said.
The weaknesses long predated the earthquake.
Experts said Venezuela’s emergency and health systems have deteriorated after more than 25 years of chronic underinvestment and a lack of long-term planning.
The country’s economic crisis accelerated a mass exodus of experienced firefighters, nurses and physicians as public-sector salaries cratered. Equipment fell into disrepair and hospitals struggled with chronic shortages of electricity, running water and medical supplies.
More than 60 percent of Venezuelans lacked regular access to health care before the earthquake, according to a report by an independent humanitarian platform, Hum Venezuela.
Experts say Venezuela still has trained and dedicated medical and emergency personnel, but not enough of them — or the resources and specialized equipment needed to respond to a disaster of this scale.
“Their salary is so low that they pay to go to work,” said Dr. Lorenzo.
For years, the government has also placed political appointees rather than technical experts at the head of many institutions, said José Araque, a geographer at the University of the Andes who studies disaster risk.
Venezuela’s scientific institutions, he added, have long identified seismic risks and produced recommendations, but successive governments failed to translate that work into public policy.
International humanitarian groups say years of political isolation also complicated the response.
Phil Gelman, Latin America director for GOAL, a humanitarian organization that operates health programs in Venezuela, said groups like his spent years operating quietly in the country because of the government’s hostile relationship with civil society, limiting the institutional relationships they normally rely on during disasters.
“We were working in the shadows,” he said. “That doesn’t get undone overnight.”
Janeth Márquez, director of the Venezuela chapter of the Catholic charity Caritas, said the country’s response has suffered from years of weak coordination between government agencies and nonprofit organizations.
“The earthquake didn’t collapse the health system,” she said. “We already had a collapsed health system.”
Carlos Alvarado, Venezuela’s health minister, said in televised remarks that the government had mobilized more than 5,000 health workers and integrated military, public and private hospitals in a unified response.
“We have managed to provide optimal care to the patients,” he said.
Tibisay Romero contributed reporting from Valencia.
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