SAN ANTONIO, Venezuela – Not everyone is healthy enough to hike perilous roads or brave a bumpy bus ride out of Venezuela where an economic collapse has prompted a humanitarian catastrophe.
Daily life is growing more dire for the thousands of patients who need dialysis. For many, the lifesaving routine was lost long ago. There are frequent power outages and there is a shortage of functioning machines.
Rina Orozco is among the patients who have been forced to cut back on their treatments. She and some 16,000 people depend on a hemodialysis machine to clean their blood, but many of the country's dialysis units are not operational.
"I have missed a lot of dialysis sessions," Orozco said in Spanish. "To the point that recently I have just been able to go once or twice a week."
A public dialysis center in the western city of San Cristobal, about 20 miles away from Colombia's border city of Cucuta, was empty during a recent visit. Seven of the 16 machines were damaged and the parts needed to repair them were not available.
The center's director said his requests to government employees, who are dealing with a health system on the verge of collapse, haven't been met.
A recent national survey from President Nicolas Maduro's political opponents and Medicos por La Salud, a nongovernmental organization, revealed there are shortages of everything from catheters, gloves, syringes to surgical supplies and anesthetic drugs.
Maduro has denied there is a crisis in Venezuela. His regime prohibits most international humanitarian aid. The president and his socialist supporters on the health ministry believe political enemies are using aid as a ploy to encourage a foreign intervention.
Solidarity Action, an advocacy group in Caracas, is pushing for international medical aid. They argue skyrocketing inflation has created the shortages of medicines and the lack of affordability.
Patients with transplants are vulnerable. Without regular access to anti-organ-rejection drugs, some are taking risks with immunosuppressants for animals and expired medications. Doctors say food shortages are causing malnutrition.
As the infrastructure crumbles, water shortages are also a problem. While there were some machines working at the center in San Cristobal, a neighboring water pump was damaged and they were forced to reschedule dozens of appointments.
Orozco's health is deteriorating, and her family's resources are dwindling. She seems to have resigned to reducing her treatments to three times a week.
"I am more likely to die," Orozco said.