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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

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


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.


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


“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.


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.


“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.


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


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.


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


“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.


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.


“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.


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


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.


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.

“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.


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.

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.


“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.

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.


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.

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.


“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.”


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.


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.


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?”