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委内瑞拉医院危机:缺水断电中的绝望与死亡

更新时间:2016-5-17 8:00:02 来源:纽约时报中文网 作者:佚名

Dying Infants and No Medicine: Inside Venezuela’s Failing Hospitals
委内瑞拉医院危机:缺水断电中的绝望与死亡

BARCELONA, Venezuela — By morning, three newborns were already dead.

委内瑞拉,巴塞罗那――上午时分,已经有三个新生儿死去了。

The day had begun with the usual hazards: chronic shortages of antibiotics, intravenous solutions, even food. Then a blackout swept over the city, shutting down the respirators in the maternity ward.

这一天是在各种惯常的危险中开始的:抗生素和静脉注射溶液持续短缺,甚至连食品也不够。之后全市停电,婴儿特护病房的呼吸机无法运行。

Doctors kept ailing infants alive by pumping air into their lungs by hand for hours. By nightfall, four more newborns had died.

几个小时里,医生们徒手把空气压入生病婴儿的肺,好让他们活下去。到了夜晚,又有四个新生儿死去。

“The death of a baby is our daily bread,” said Dr. Osleidy Camejo, a surgeon in the nation’s capital, Caracas, referring to the toll from Venezuela’s collapsing hospitals.

“婴儿死亡已经是我们家常便饭,”委内瑞拉首都加拉加斯的外科医生奥斯莱迪丝·卡梅霍(Osleidy Camejo)说。他指的是委内瑞拉崩溃的医院系统,导致了这样的局面。

The economic crisis in this country has exploded into a public health emergency, claiming the lives of untold numbers of Venezuelans. It is just part of a larger unraveling here that has become so severe it has prompted President Nicolás Maduro to impose a state of emergency and has raised fears of a government collapse.

委内瑞拉的经济危机已经爆发为公共健康危机,目前因此丧生的委内瑞拉人数多少尚不得而知。这只是委内瑞拉更大的一场乱局的一部分,态势愈发严重,委内瑞拉总统尼古拉斯·马杜罗(Nicolás Maduro)宣布国家进入紧急状态,人们担忧政府会崩溃。

Hospital wards have become crucibles where the forces tearing Venezuela apart have converged. Gloves and soap have vanished from some hospitals. Often, cancer medicines are found only on the black market. There is so little electricity that the government works only two days a week to save what energy is left.

医院病房成了这个国家各种破坏性力量交汇的坩埚。有些医院已经找不到手套和肥皂。通常治疗癌症的药品只能在黑市买到。委内瑞拉总是电力不足,为了省电,政府每周只工作两天。

At the University of the Andes Hospital in the mountain city of Mérida, there was not enough water to wash blood from the operating table. Doctors preparing for surgery cleaned their hands with bottles of seltzer water.

安第斯医院大学坐落在山城梅里达,这里没有足够的水去清洗手术台上的血迹。准备手术的医生们用瓶装矿泉水洗手。

“It is like something from the 19th century,” said Dr. Christian Pino, a surgeon at the hospital.

“就像回到了19世纪,”医院的外科医生克里斯蒂安·皮诺(Christian Pino)说。

The figures are devastating. The rate of death among babies under a month old increased more than a hundredfold in public hospitals run by the Health Ministry, to just over 2 percent in 2015 from 0.02 percent in 2012, according to a government report provided by lawmakers.

数据是灾难性的。根据议员提供的政府报告,2015年,在卫生部开设的公立医院内,一个月以下婴儿的死亡率达到了2%,比2012年的0.02%增加了100倍。

The rate of death among new mothers in those hospitals increased by almost five times in the same period, according to the report.

根据这份报告,同一时期这些医院中的产妇死亡率也增加了将近五倍。

Here in the Caribbean port town of Barcelona, two premature infants died recently on the way to the main public clinic because the ambulance had no oxygen tanks. The hospital has no fully functioning X-ray or kidney dialysis machines because they broke long ago. And because there are no open beds, some patients lie on the floor in pools of their blood.

在加勒比港口城市巴塞罗那,前不久,两个早产儿在去往市公共医院的途中去世,因为救护车上没有氧气瓶。医院没有能完全正常运转的X光设备和肾透析设备,因为它们早就坏了。因为没有床位,许多病人躺在地上,躺在自己的血泊之中。

It is a battlefield clinic in a country where there is no war.

在这个没有战争的国家,这里却如同战地医院。

“Some come here healthy, and they leave dead,” Dr. Leandro Pérez said, standing in the emergency room of Luis Razetti Hospital, which serves the town.

“有些人进来的时候很健康,结果却死在这里,”莱安德罗·佩雷兹(Leandro Pérez)医生在镇医院路易斯·拉兹蒂医院的急诊室里说。

This nation has the largest oil reserves in the world, yet the government saved little money for hard times when oil prices were high. Now that prices have collapsed — they are around a third what they were in 2014 — the consequences are casting a destructive shadow across the country. Lines for food, long a feature of life in Venezuela, now erupt into looting. The bolívar, the country’s currency, is nearly worthless.

这个国家拥有世界上最大的石油储量,然而政府在石油价格高时却没有积蓄任何金钱以备不时之需。如今石油价格一落千丈,仅相当于2014年的三分之一,其结果令整个国家蒙上了毁灭性的阴影。购买食品的长队在委内瑞拉早已屡见不鲜,现在情况恶化成了抢劫。这个国家的货币玻利瓦尔已经近乎一文不值。

The crisis is aggravated by a political feud between Venezuela’s leftists, who control the presidency, and their rivals in congress. The president’s opponents declared a humanitarian crisis in January, and this month passed a law that would allow Venezuela to accept international aid to prop up the health care system.

委内瑞拉政治势力之间的夙怨进一步加剧了危机,斗争双方是控制着总统职位的左派和他们在议会中的对手。1月,总统的反对者宣布委内瑞拉正在发生人道主义灾难,本月又通过一项法律,令委内瑞拉可以接受对卫生健康系统的国际援助。

“This is criminal that we can sit in a country with this much oil, and people are dying for lack of antibiotics,” says Oneida Guaipe, a lawmaker and former hospital union leader.

“在一个拥有这么多石油的国家,人们还因为缺乏抗生素而死,这是一种犯罪,”议员及前医院工会领导人奥奈达·瓜伊佩(Oneida Guaipe)说。

But Mr. Maduro, who succeeded Hugo Chávez, went on television and rejected the effort, describing the move as a bid to undermine him and privatize the hospital system.

但是乌戈·韦查斯(Hugo Chávez)的继任者马杜罗在电视上反对这项努力,称之为对他本人的颠覆,以及试图将医疗系统私有化。

“I doubt that anywhere in the world, except in Cuba, there exists a better health system than this one,” Mr. Maduro said.

“我怀疑世界上除了古巴,还有哪个国家拥有比我们更好的卫生系统,”马杜罗说。

Late last fall, the aging pumps that supplied water to the University of the Andes Hospital exploded. They were not repaired for months.

去年秋末,安第斯大学医院年久失修的水泵爆裂了,几个月未能得到修理。

So without water, gloves, soap or antibiotics, a group of surgeons prepared to remove an appendix that was about to burst, even though the operating room was still covered in another patient’s blood.

于是外科医生只能在没有水、手套、肥皂和抗生素的情况下,为病人切除近乎破裂的阑尾,手术室里还残留着上一位病人的鲜血。

Even in the capital, only two of nine operating rooms are functioning at the J. M. de los Ríos Children’s Hospital.

就连在首都的J·M·德·洛斯·里奥斯儿童医院,九间手术室中也只有两间能用。

“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.

“成人因为缺乏药物死去,孩子们因为营养不良死去,还有些人因为缺乏医护人员死去,”医院的一位外科医生娅米拉·巴塔利尼(Yamila Battaglini)说。

Yet even among Venezuela’s failing hospitals, Luis Razetti Hospital in Barcelona has become one of the most notorious.

然而,尽管委内瑞拉的医院情况都在恶化,但巴塞罗那的路易斯·拉兹蒂医院却格外声名狼藉。

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.

4月,官方逮捕了院长阿基莱斯·马丁内斯,并解除了他的职务。据本地新闻报道,他以偷窃医院设备被起诉,包括治疗呼吸系统疾病的仪器,以及静脉注射溶液和127箱药物。

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.

前不久,夜里10点的时候,弗莱迪·迪亚兹(Freddy Díaz)医生走进充当临时病房的走廊,这里没有床位,有些人躺在地上,抓着浸透鲜血的绷带呼救。有个被铐在推车上的人是警察送来的。医疗用品储藏室的门一开,蟑螂四散而去。

Dr. Díaz logged a patient’s medical data on the back of a bank statement someone had thrown in the trash.

迪亚兹拿过一张从垃圾堆里捡来的银行结算单,在背面写下一个病人的医疗数据。

“We have run out of paper here,” he said.

“我们纸不够用了,”他说。

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.

在第四层,他的一位病人,68岁的罗萨·帕鲁乔(Rosa Parucho)是少数弄到了床位的人之一,尽管腐烂的床垫让她后背生满了疮。

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.

但这对她来说已经是小问题了,身患糖尿病的帕鲁乔女士无法接受肾透析,因为机器坏了。感染蔓延到她的脚,那天夜里已经变成黑色。她陷入了感染性休克。

Ms. Parucho needed oxygen, but none was available. Her hands twitched and her eyes rolled into the back of her head.

帕鲁乔需要氧气,但是没有能用的氧气机,她双手抽搐,两眼翻白。

“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.

“细菌没有死掉,而是在繁殖,”迪亚兹医生说,并指出帕鲁乔需要的三种抗生素已经缺货好几个月了。

He paused. “We will have to remove her feet.”

他顿了一下。“我们得给她双脚截肢。”

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.

三个亲戚围着一个昏迷的女人,读着《旧约》。她是六天前来的,但是由于扫描设备坏了,几天之后医生才发现肿瘤已经占据了她前额叶的四分之一。

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.

21岁的萨缪尔·卡斯特罗(Samuel Castillo)进入急救室时需要输血,但血液储备已经用完。为了省电,国家宣布全国放假,血库只在工作日才接受献血。卡斯特罗当晚去世。

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.

在过去的两个半月里,医院没有办法打印X光片。病人必须使用智能手机拍下图像,然后拿给医生看。

“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.”

“像是肺结核,”急救医生看着手机上的肺部扫描照片。“但是我说不清,照片质量太差。”

Biceña Pérez, 36, scanned the halls looking for anyone who would listen to her.

36岁的毕塞娜·佩雷兹(Biceña Pérez)扫视大厅,希望找到可以帮忙的人。

“Can someone help my father?” she asked.

“有人能帮帮我父亲吗?”她问。

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.

她的父亲,61岁的何塞·卡尔沃(José Calvo)患有寄生虫引起的美洲锥虫病。但是这一年,当地治疗这种病所需的药物用完了,他开始出现心脏衰竭。

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.

佩雷兹的呼救已经过去了六个小时,一声尖叫从急救室传来,是卡尔沃的姊妹:“亲爱的,亲爱的,”她哭着。卡尔沃去世了。

His daughter paced the hall alone, not knowing what to do. Her hands covered her face, and then clenched into fists.

他的女儿一个人走在大厅里,不知道该做什么才好,她双手捂着脸,接着攥成了拳头。

“Why did the director of this hospital steal that equipment?” was all she could say. “Tell me whose fault is this?”

“这家医院的院长为什么要偷设备,”这是她唯一能说出口的话。“告诉我这到底是谁的错?”

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