With no medicine and a crippled health system, a family loses hope in the country they love.

The Intensive Care Unit of the Centro Médico in Caracas. Manu Quintero

CARACAS, Venezuela — It took me a second to understand that the sound interrupting my prayers was a phone ring. It was 5 a.m. here in the capital of my home country. I’m not used to landlines anymore. My cell usually vibrates. My heart sank.

“There’s been a complication,” the doctor at the intensive care unit uttered in a very low voice. “You should all come right away.”

My mom, two siblings and I were already up. We hadn’t been sleeping much since my dad was hospitalized for the flu. We were all fully dressed in the elevator in less than 10 minutes.

The sun was barely starting to come out as my brother hurriedly drove around Caracas, where my parents still lived.

Family photos of the Atencios decorate their Caracas home. Manu Quintero

I noticed graffiti in my old neighborhood, Altamira, which had been taken over by student protesters last year: “We gave our lives for you. Don’t forget us.”

I hadn’t been in Caracas in almost a year, when nationwide marches rocked the country for more than six months. Over 100 people died and thousands were injured protesting the increasingly authoritarian government of Nicolás Maduro.

Now, the same streets that would usually be filled with traffic and demonstrators were empty.

As many as 4 million Venezuelans have abandoned the country in the last few years. Last month the United Nations finally called the Venezuelan exodus a “refugee” crisis.

Nearly 10 years ago, I left Venezuela after college, looking for a better future. My dad’s sudden illness had forced me to come back.

Saved by a stick of butter

Our ordeal started almost a month earlier, when my mom told us that my 72-year-old father was feeling under the weather after visiting me in Florida after the holidays.

Miami Mexico Caracas Venezuela Colombia Brazil 1000 miles Miami 500 miles Caracas Venezuela Colombia Brazil by NBC News

A couple of days later, my brother called me from Colombia, where he works, with the news that our dad had been placed in the ICU.

“Dad got a complex pneumonia caused by the flu,” he said, with desperation in his voice. “You need to get down there as fast as possible with whatever meds are needed.”

I had just read the headlines about Marcos Carvajal, the former Colorado Rockies and Miami Marlins pitcher, who died of pneumonia in Venezuela less than a month earlier. His colleagues said his condition worsened because of the lack of medicine. I shivered at the thought of a 33-year-old man dying of the same illness that my father, 40 years older, was struggling with.

How are we going to solve this, Ms. Atencio? Customs agent, Simon Bolivar International Airport

After our phone call, my brother sent me a doctor’s prescription containing the list of urgently needed medicines to treat Dad. None of them was available in Venezuela.

I had to get everything in a few hours. His doctors were literally waiting for me to hand-deliver them. It was a race against time. My father’s survival would depend on us somehow getting around Maduro’s regime, where there is a shortage or total scarcity of almost everything, including cash.

Twenty-four hours later, I landed at Simon Bolivar International Airport with more than $5,000 worth of meds in my carry-on: Trimetropin (800mg) 96 doses in injectable form; Voriconazol (200mg) 20 doses in injectable form; 15 pills of Prednisona (50mg)… They and others were all used to beat flu-related infections.

The customs agent in the backroom of the airport — the one with the “socialist control” sign on the door — took one look inside my suitcase and was dubious. “How are we going to solve this, Ms. Atencio?” she asked.

Then I noticed her eyes avidly looking at a stick of butter in my handbag. Yes, butter! The one thing my aunt had asked me to bring for her from the U.S. Like other basic goods, butter has become so rare in Venezuela it’s the equivalent of liquid gold.

So I turned in the butter and a couple of hundred dollars in taxes to get by customs. Not a bad start.

Dad was hospitalized at Centro Médico, the Medical Center of Caracas, one of the best private clinics in the country, where I turned in the antibiotics and immediately made a little office for myself in one corner of the ICU. From that moment on, I somehow became part of the medical team.

At the ICU, rosary in hand. Taking over a small corner of the hospital.

The flu had weakened Dad’s immune system, which was attacked by subsequent infections. Almost every day, the doctors came to us with a list of at least three or four new medications or supplies they said were needed to treat him: Tigeciclina (50mg) 10 doses in injectable form; Caspofungina (50mg) 10 doses in injectable form; Colistin (50mg) 10 doses in injectable form; a feeding tube and Ensure to keep him nourished; an anti-embolism machine for his legs; an anti-bedsore mattress for the ICU…

We began to resent the never-ending requests. “How are we supposed to get this stuff?” I first thought to myself, feeling powerless and deprived of the usual resources I would have in the U.S.

I started putting out desperate notices on my social media and WhatsApp chats: “Can anyone help!?”

Most people suggested I go to the Venezuelan black market for medicine as the quickest way. These traders will sell you whatever supply is available, but at four times the usual price, at the least. But even if you can pay them, it’s a risky move, as you have no way of knowing whether the medication is real or expired.

One family sitting next to us in the ICU waiting room was packing their bags and leaving for the countryside. They told me they couldn’t afford to keep their relative in the hospital anymore.

Conditions worse than in the Great Depression

Venezuela has been in a downward spiral for years, caused by a combination of mismanagement of government funds and the plummeting price of oil.

Skyrocketing inflation has created extreme shortages of food, medicine and other essentials, while planned (and unplanned) power outages are common throughout the country and don’t discriminate between critical services like clinics and hospitals and the average household.

Francia Square in the Altamira neighborhood of Caracas became the center of mass protests last year. Manu Quintero

Hundreds of thousands of people have been crossing the border to Colombia to get treated. Health officials say Venezuelans made nearly 25,000 visits to Colombian ERs last year, up from just 1,500 in 2015.

According to Harvard economist Ricardo Hausmann, who was Venezuela’s minister of planning in the early 1990s (and is now deemed persona non grata by the government for his fierce criticism), the crisis is significantly worse than the Great Depression was in the United States.

In his opinion, the economic collapse started in 2000, when President Hugo Chávez changed the constitution and got the National Assembly to grant him the power to pass laws through presidential decree. In one day, he passed 48 laws that no one had read or discussed.

Little by little, the Chavista government took control of the private sector, especially the oil company PDVSA, where Chavez fired 20,000 of its 35,000 employees. When the majority of those employees left the country after being persecuted, Venezuela lost most of the know-how of the oil industry. It was a massive loss of human capital.

The state of health care in Venezuela today is comparable to that of the poorest nations in the world.

Many economists criticized Chávez for widespread mismanagement of his country’s oil industry, and after he won re-election in 2006 he made a clear move toward socialism. He nationalized the telephone company, owned by Verizon; three cement companies owned by Mexican corporations; one of the largest banks owned by Banco Santander; and the steel company, to name just a few.

Chávez died in March 2013. Around that time, the international market decided not to lend Venezuela money anymore. The country went into a recession, and the exchange rate rose sharply. Then in 2014, the price of oil collapsed. That was the beginning of the end.

After almost 20 years of a socialist revolution that started when I was 14, everything has deteriorated. Incomes have collapsed to a degree that is hard for anyone outside of the country to understand. To give you an example, I recently interviewed a public school teacher with 20 years experience whose average monthly salary is less than the cost of a carton of eggs. That collapse in private incomes affects public services, like health care.

The state of health care in Venezuela today is comparable to that of the poorest nations in the world. Strapped for cash and facing dropping oil prices, the Maduro government has put strict limits on importing food, basic goods and medicine.

Graffiti reading “dictatorship” covers a wall along Altamira’s main road. Manu Quintero

Local human rights organizations cited by Amnesty International have said Venezuela is suffering from an 80-90 percent shortage in medicine supplies; half of the country’s hospitals are not working; and there has been a 50 percent drop in the number of medical staff at the public hospitals that provide 90 percent of health services. There have been numerous reports of tuberculosis and diphtheria outbreaks.

According to one survey, water is rarely available at many health facilities in Venezuela. Many intensive care units have been shut down because they’re unable to operate, and the vast majority of open ICUs have intermittent failures because of a lack of supplies. Almost a quarter of pediatric ICUs have closed.

To make matters worse, Maduro has refused to allow humanitarian aid to enter the country, especially from the U.S., stating that it could pave the way for a “foreign intervention.”

Smuggling bags of fluid across the border

Back in the hospital, my social media feed showed thousands of patients in the countryside protesting the lack of medicine. A sense of isolation and doom engulfs me: We are alone in this humanitarian crisis, which the rest of the world seems to ignore.

Watch: The Healthcare Crisis in Venezuela To view this video please enable JavaScript, and consider upgrading to a web browser that supports HTML5 video Video by Miguel Alfredo López, Geraldine Cols Azócar, & Mariana Atencio

I kept my corner of the ICU for three weeks straight, sometimes squatting on the floor, like a kid who hides under the table when she’s scared. I prayed or talked to Dad both silently and out loud. Most days I cried in that corner. But I also had moments of hopeful joy when I was able to procure his medicine.

The hunt for medicine gave us something to focus on.

We have the dialysis machine, but not the actual bags with the fluid. Dr. Jerry Gomez, Medical Center of Caracas

From Day One, I was well aware that we were extremely lucky. Family, friends and even people who heard our story on social media brought us meds and supplies from the U.S. and other countries.

Three weeks in, my dad’s kidneys started failing. We were told that he would need dialysis treatment, which presented us with the biggest challenge yet.

“We have the dialysis machine, but not the actual bags with the fluid,” Dr. Jerry Gomez, who is in charge of the ICU, told me. “You need to find 40 bags of 5 liters each for him to complete the treatment.”

We shared the message with all our contacts and quickly realized the only way to acquire that many dialysis fluid bags in time would be to find them in neighboring Colombia and smuggle them across the border.

We got the name of the manufacturer and set out to contact relatives in Colombia. Unfortunately, they were told the company won’t sell to patients in Venezuela because of U.S. sanctions against the Maduro government.

A friend found a doctor willing to concoct a fake patient in order to get the company to sell the bags. Now we just had to figure out how to bring the 40 bags from Colombia to Venezuela.

Dr. Jerry Gomez leads the ICU at the Centro Médico. Manu Quintero

My brother suddenly got off the phone with a smile. “Our uncle has a friend who used to import books from Colombia,” he said. “He has a contact who can place the bags in his truck across the border.”

As a law-abiding citizen and a journalist, I thought about the ethics behind the whole situation. In the past few weeks, I had come into the country with thousands of dollars in antibiotics; texted with black market traders, who are partly to blame for hoarding meds and hiking prices; and now was arranging to try to smuggle dialysis fluid across the border.

But with my father’s life on the line, I had no sense of what is right or wrong anymore. A struggle for survival is everyday life in Venezuela for so many people. It was like a weird Latin American sequel to “The Hunger Games.”

When we told the medical staff our plan to get the dialysis bags, they seemed genuinely relieved. I later got an “excellent job!” text from one of the doctors.

Help and despair

I got to know the doctors well. Overcoming daily challenges. Having to inform patients they don’t have meds. Lacking appropriate equipment. Begging to get paid in dollars to make a living.

Three-quarters of the doctors who have left the Medical Center of Caracas have done so in the last two years, according to its director, Dr. Francisco Javier Márquez. The majority has left for Chile, Ecuador or Argentina, where it’s easy to revalidate their licenses. The brain drain is massive.

“There is actually a sense of mysticism and camaraderie when you work in these conditions,” says Dr. Jorge Valeri, my father’s main doctor and cardiologist. “You have to save lives no matter what.”

Dr. Jorge Valeri, a cardiologist at the Centro Médico. Manu Quintero

I was thinking about all of this as we headed into the hospital after that 5 a.m. phone call, on the same day the dialysis bags were set to cross the Colombian border.

When we finally arrived in the ICU, the doctor’s face said it all. His voice trailed off as he informed us Dad had suffered from sepsis-induced cardiac arrest. Although they had resuscitated him multiple times, in the end they were unsuccessful.

I couldn’t make out the rest of it. I just heard my mom wail as she threw herself over my dad’s body. It’s a sound I’ll never forget. A primal cry. A wounded animal’s whine. She’s usually so strong. My sister followed suit. My brother and I were numb.

After what seemed like an eternity, my family left the room. We couldn’t stand the pain for another minute. Being his firstborn, I felt like I had to stay with him for as long as I could. I stood in my corner, tears rolling down my cheeks. I played the song from our favorite movie on repeat, “As Time Goes By” from “Casablanca,” until he was placed in a black body bag and taken away.

A million images came to my mind. I remember him protesting in the streets of Caracas over the years, side by side with the students who would give up their lives. My father believed in Venezuela’s recovery until his last breath. But for me, any hope that Venezuela would get better any time soon left with him in that black bag.

Living through Venezuela’s health crisis first-hand taught me about the depths of human despair, but also about the solidarity of human beings in the worst possible circumstances. I was helped by so many people I can’t even count them. I was also able to bring medicine for people I didn’t know before this ordeal. After this experience, I emerged as a grown-up from that corner of the ICU. (The dialysis bags never made it across the border before Dad died, so no crime of smuggling ever took place.)

As I boarded my return flight to Miami, I thought about what I left behind. My mom. The patients at that hospital in Caracas. The doctors. The millions of people who can’t afford basic medical care. I looked out of the airplane window and clung to the little wooden box holding my dad’s ashes. So many more will die. A part of me died here, too.

During a family vacation in Mexico at the start of 2018.