Hypertensive and diabetic, Juan Villamizar, 65, is relatively lucky: he found a place in a public dialysis center.

In Venezuela, hard hit by an economic crisis for eight years, with a struggling public service, finding where to get dialysis is a challenge.

A few weeks ago, a spike in his blood pressure sent him to the emergency room.

He spent twenty days in the hospital.

Diagnosis: his kidneys no longer function at 10% of their capacity.

He then had to find a place to do three dialyses a week.

For lack of budget and machines, the university clinic that treated him reserves his own for hospitalized patients.

For those who leave the hospital, the ordeal begins.

"It's dramatic (...) There are not enough centers", says Mr. Villamizar.

He owes his place at the Hugo Chavez Dialysis Center in Caracas to the perseverance of one of his sons, Edwin, who knocked on the doors of dozens of hospitals, clinics and centers for weeks.

Each time, the same litany: "No place".

A nurse's response marked him: "Join the waiting list, if someone dies..."

Those who have the means -- and/or good insurance -- can go private, where each session costs around $1,000.

Impossible for the Villamizar family as for most Venezuelans.

Juan Villamizar, whose kidneys only work at 10%, settles, helped by his daughter, in a room of a hospital in Caracas, on March 16, 2022 in Venezuela Pedro Rances Mattey AFP

The healthcare system for people with kidney problems has "collapsed" since 2015, according to a report by the Coalition of Organizations for the Right to Health and Life (Codevida).

"A consequence of the dismantling of essential health institutions and services," said the NGO.

5,000 deaths?

Some 15,000 Venezuelans were treated in 2016 through the Social Security dialysis program.

"Many of these people died. Today (...) there are less than 6,000 patients," said Francisco Valencia, director of Codevida, to AFP.

There are no official figures.

Carlos Rotondaro, a former health minister accused of corruption and now an opponent, estimates that 5,000 patients with kidney problems died between 2017 and 2019.

A patient in a wheelchair leaves the hospital after undergoing dialysis on March 16, 2022 in Caracas, Venezuela Pedro Rances Mattey AFP

At the Concepcion Palacios maternity hospital, one of the largest in Caracas, there is only one dialysis machine and it only works because a patient's family has financed its repair.

“The collapse” occurred before the international sanctions against Venezuela, assures Mr. Valencia, while the power attributes the deficiencies of the health system to the sanctions imposed by Washington and by part of the international community to protest against the re-election of President Nicolas Maduro in a vote boycotted by the opposition.

The government is trying to remedy the situation with the reactivation of certain centers.

A few days ago, he inaugurated a dialysis center and a transplant center, another disaster-stricken health sector.

Juan spends an average of three hours per session in the dialysis room.

A patient points out that the center sometimes experiences a shortage of water.

There is indeed a 10,000 liter cistern but the cuts, frequent in the country, mean that it can be emptied faster than it fills up...

Another difficulty is the lack of staff.

Thousands of doctors and nurses are among the five million people who have left the country since 2015. "We have cases where the families or the patient himself has to connect the patient to the machine," says Mr. Valencia.

A nurse monitors the dialysis of a patient with kidney failure, in a hospital in Caracas, on February 24, 2022 in Venezuela Yuri CORTEZ AFP

Juan has another problem: he has a little fever and his relatives think that the catheter placed in his chest (and to which he connects for each session) has become infected.

He would like to change it for another on the arm where it would be more comfortable.

But it costs $120.

Too expensive.

© 2022 AFP