Venezuela quakes push fragile health system to the brink

Earthquake victims are overwhelming healthcare centers in Venezuela’s coastal state of La Guaira and beyond, pushing an already fragile health system past its limits.

Two powerful 7.2 and 7.5 earthquakes struck within a minute of each other on Wednesday evening, toppling buildings and severely damaging the country’s main international airport. By Saturday afternoon, authorities reported nearly 3,240 injured people and a death toll approaching 1,430 nationwide. More than 430 aftershocks had occurred by Saturday, head of the National Assembly said in a report.

The first wave of patients was mainly survivors suffering crush injuries and multiple fractures after being pulled from collapsed buildings. But physicians warn the crisis is entering a more dangerous phase as people trapped for days beneath the rubble began arriving with kidney failure, crush syndrome and limbs that can no longer be saved. Skin infections, gastrointestinal illnesses and psychological trauma are expected to follow in the coming weeks.

Authorities have restricted access to La Guaira to allow rescue operations to continue uninterrupted while reducing public health risks, acting President Delcy Rodríguez said in a 1 a.m. update on Saturday. According to her, the restrictions would enable health authorities to implement sanitary measures, including the management of victims’ remains.

The earthquakes are already testing a healthcare system weakened by years of economic collapse, shortages and the exodus of medical workers.

“This new national tragedy strikes while Venezuela remains in a prolonged humanitarian emergency,” said Huníades Urbina, a pediatric intensive care physician and member of Venezuela’s National Academy of Medicine. “We already lacked the capacity to care for patients on an ordinary day. Imagine what happens when hundreds of people emerge from collapsed buildings needing emergency treatment.”

According to Urbina, public hospitals entered the disaster with shortages of emergency supplies and surgical material, about half the hospital beds they once had, and radiology equipment that is largely obsolete or no longer functioning. Around 30% of the country’s physicians and 70% of its nurses have left Venezuela over the past decade, he said, citing figures from the Venezuelan Medical Federation.

The shortages are evident inside La Guaira’s healthcare centers. At one outpatient clinic on Thursday, electricity was available only through a backup generator powering the vaccine refrigerator. Patients were lying on mattresses, benches and the parking lot pavement because treatment rooms were full, while doctors improvised additional care areas outside the building.

Venezuela’s healthcare system was struggling long before the earthquakes, said Jaime Lorenzo, director of the nonprofit organization Médicos Unidos de Venezuela. Patients routinely pay out-of-pocket for diagnostic tests and are often expected to bring their own medical supplies.

At Ricardo Baquero González Hospital in Caracas, nurses, physicians and medical students worked through the night after the earthquakes. The hospital had only 12 nurses on duty, but “they multiplied themselves by 10,” Lorenzo said.

By 10 p.m. Wednesday, just four hours after the quakes, the hospital had exhausted critical supplies, including elastic bandages and tetanus vaccines. Residents began arriving with whatever they could spare, including one man who donated diapers that had belonged to his late mother.

“In the first phase, the donations came from Venezuelans themselves,” Lorenzo said.

Now, the international response is gathering pace. By Saturday morning, Venezuela had received 17 flights carrying more than 1,600 rescue personnel, with another 25 expected over the following 24 hours, Deputy Minister Oliver Blanco said in a post on X. The U.S. also deployed two military ships, including the USS Fort Lauderdale, to support logistics and receive patients airlifted for emergency treatment. Mobile field hospitals were due to arrive on Saturday, U.S. officials said.

Washington is mobilizing $150 million in humanitarian assistance and is preparing an additional aid package worth hundreds of millions of dollars. Separately, CAF, the Development Bank of Latin America and the Caribbean, launched a recovery fund with an initial $1 million contribution, adding to a previously announced $300,000 humanitarian donation, and appealed for international and private-sector support.

Until those resources are fully in place, in La Guaira, healthcare centers improvise medical tents and mobile units, while humanitarian organizations rushed supplies to overwhelmed facilities.

One such group is Project HOPE, which accelerated deliveries that would normally be spread over several weeks. It sent 15 to 20 pallets of medicines, equipment and emergency supplies Friday to hospitals and outpatient centers in La Guaira and the neighboring Miranda state.

“The demand has been extraordinarily high since Thursday night,” said César Jiménez, Project HOPE’s grants and projects manager in Venezuela. “We’re increasing the volume of supplies we normally distribute and bringing them forward because hospitals need them now.”

In Caracas hospitals, physicians are increasingly treating survivors suffering the consequences of prolonged entrapment beneath collapsed buildings. Many arrive severely dehydrated after spending days without food or clean water, developing rhabdomyolysis — a condition in which damaged muscle tissue releases toxins into the bloodstream — leading to acute kidney failure. Others require amputations after crushed limbs lose their blood supply.

Doctors have also begun organizing outside hospital walls. Volunteer physicians are offering free telemedicine consultations through social media for minor ailments in an effort to reduce pressure on emergency rooms, while psychiatrists are publishing guidance to help survivors cope with anxiety and trauma.

In hospitals, doctors compile handwritten lists of patients who were admitted and post them on entrances to help families who are searching for missing relatives. Isabel González-Bocco, a Venezuelan physician living in Boston, has been collecting such records and other information from doctors, journalists and patients’ relatives before digitizing them into spreadsheets that have become one of the main tools families use to locate loved ones.

“Everything is being managed by civilians,” González-Bocco said.

Her registry contained about 3,000 hospitalized patients by Friday afternoon, though she cautioned the number remains incomplete because many victims arrived without identification documents. On Saturday, authorities said there had been more than 12,000 consultations in the disaster area, including some 7,500 rapid triage. The dead retrieved from collapsed buildings are taken directly to morgues.

Meanwhile, an opposition-run platform listed more than 55,500 people missing as of Saturday, while more than 13,200 previously reported missing had been located.

Some private hospitals have also opened their doors free of charge. One Caracas clinic treated more than 20 earthquake victims Wednesday night but had received only two by Friday, both transferred from La Guaira. Traumatologists and surgeons volunteered to reinforce emergency departments.

Doctors say the burden on hospitals is likely to shift rather than disappear.

“We worked with whatever we had,” Lorenzo said after finishing his shift at the Ricardo Baquero González Hospital. “But we received every patient who arrived — and they are still arriving.”