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Nightmare in Venezuela: How a scraped knee nearly killed a 3-year-old girl

Venezuela used to be Latin America’s richest country, but it is now falling apart as a plunge in the price of oil caps off years of economic mismanagement. Local production of almost everything has stalled, and there is little money to import medicine.

The left-wing administration of President Nicolas Maduro calls the medical crisis an invention peddled by opponents of the country’s 17-year-old socialist revolution. The week Ashley was hospitalized, Maduro went on television and called on Venezuelans to start growing medicinal herbs.

The government has refused to let in humanitarian aid. So donations of medical supplies sit in warehouses and shipping containers in countries including the U.S., Spain and Panama.

In Ashley’s hospital, the janitorial staff had run out of bleach to clean the floors. Stray dogs wandered the building, and cockroaches scuttled by on the walls. The water in the bathroom sometimes came out black.

And in her emergency care room, the sink was broken, the soap dispenser was empty and there was nothing in the container marked “sterile gloves.” Yet with the hospital so crowded that women in labor were sharing beds, her parents felt lucky she had been admitted at all.

Doctors diagnosed her with a staph infection. Bacteria had entered the tissue near her knee, and were burrowing into her joint.

They set up an IV drip and poured in the last of the hospital’s supply of vancomycin, a widely used antibiotic. Dazed, her father watched the green line on her heart monitor loop up and down.

Maykol’s own father had walked out when he was 12, and he’d had dreams of a big, stable family. He tattooed the names of his children on his arms, and stopped home every afternoon to have lunch with them.

With the arrival of a third baby this summer, Maykol had quit his job as a sound technician and started driving a taxi to make more money. They had 80,000 bolivars saved -- about three month’s wages. What would happen to that cushion now, he wondered?

As night fell, Ashley got dramatically worse. The green heart monitor line began to zigzag wildly. Her breathing sounded strange, like hoarse hiccups. And Maykol noticed with a start that her chest was moving the wrong way with each inhalation, collapsing inward instead of puffing outward.

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In this Aug. 17, 2016 photo, Maykol Pacheco sits with his 3-year-old daughter Ashley, on balcony at the University Hospital in Caracas, Venezuela. 

Ariana Cubillos, AP

Doctors suspected bacteria had traveled from her knee to her lung and eaten a hole there. But the hospital’s last X-ray machine had given out the month before. The only way to know for sure was to risk transporting Ashley to a private clinic, where the test would cost the family a week’s wages.

Two doctors went with them in an ambulance, ready to pump air manually into Ashley’s lungs if she went into respiratory arrest.

The X-ray confirmed their fears: Ashley’s right lung had collapsed like a balloon. With each breath she took, air was leaking into her chest, putting pressure on her heart.

Back at the hospital, Ashley sounded like she was drowning. Her breath came in irregular gasps. Doctors looked for the apparatus that could save her: a Pleur-evac chest drainage machine that sells for $100 in the U.S. The hospital had a few, but they were locked away. Like all hospitals here, University Hospital has been pillaged, even by staff, as supplies become rare and valuable contraband.

The emergency room doctors made do with a trick from battlefield medicine instead.

As night fell, they gathered around the crying girl and slid a large needle into her chest. Air came whooshing out. Normally, medics would then insert a one-way valve, but there was none to be found. Still, little by little, Ashley’s hiccupping breaths grew less frantic.

Doctors then called her parents out into the hall. The hospital’s supply of the intravenous antibiotic was nearly gone. And without a chest drainage machine, Ashley wouldn’t live to see the next evening.