Desperate to cure the cancer growing in her breast, Yasmary Díaz piled her three children into the back of a pickup truck and made the bone-jarring trip from her home in Guarenas to rural Zamora, up a steep and deeply rutted mountain path to a shack built of dried mud and tree branches. Here, at an altar high in the remote mountainside surrounded by mandarin trees, she sought out a shaman, a traditional healer who would call upon a powerful spirit to rid her of her disease.

According to custom, Díaz lay down on the bare dirt, surrounded by flickering candles and intricate patterns drawn in white chalk, and closed her eyes. Standing over her in a cloud of cigar smoke, Edward Guidice, bare chested with strands of colorful beads and wild boars’ teeth draped around his neck, began to pray aloud—invoking a pantheon of saints and spirits of the religious cult of María Lionza to send the spirit of an elderly man, Emeregildo, who had died decades before, to take over his body and cure Ms. Díaz of cancer.



Díaz, 28, is one of thousands of Venezuelans now flocking to spiritual healers because their health care system is in crisis—part of the broader economic collapse that has caused widespread medicine shortages that have crippled the public hospitals in the wake of the late president Hugo Chávez’s profligate socialist revolution.

Venezuela produces negligible amounts of medicines, and the chronic shortages can be traced mainly to policies the government put in place to control international currency exchanges. To buy medicines from abroad, pharmacies and individuals must be approved by the government, and only rarely is permission given.

N. Amer. Caracas Venezuela South America NGM MAPS

The Venezuelan Pharmaceutical Federation reports that more than 85 percent of basic medicines are impossible or difficult to find. Pharmacy shelves are bare, and public hospitals turn patients away for lack of supplies. In a survey of 92 state-run hospitals published in March 2017 by the Venezuelan nonprofit Physicians for Health, 78 percent reported having no medicines or severe shortages. The same survey also found that 89 percent of hospitals can’t regularly perform x-rays and that 97 percent of medical labs aren’t functioning at full capacity.

Mediums devout to María Lionza channel dozens of spirits: doctors, indigenous people, elderly campesino men, also Vikings, military leaders, gangsters, and women who dance and wear colorful dresses. Guidice, however, is the only medium who can call on Emeregildo, and Emeregildo is believed to have stronger healing capabilities than most other spirits. Emeregildo is a brash and quick-witted spirit with a long white beard, who walks hunched over with a cane, and always asks for coffee when he appears. Multiple patients say Emeregildo has cured them of terminal illnesses. Others say they were lame and that he enabled them to walk again. The sick from across Venezuela regularly journey to Guidice’s mountain shack in hopes that Emeregildo will cure them, too.

The day Yasmary trekked up searching for a cure, Guidice, cup of coffee at hand, knelt down, grazed her breast with a razor blade, and covered it with wads of red hibiscus flowers to symbolized a thick incision. Leaning in to within inches of her chest, he puffed on his cigar, alternately blowing smoke on the skin above the tumor and dripping red candle wax on it. Tobacco smoke is believed to absorb sickness, and when the ash changes color from black to white, healing is said to be taking place.

For Díaz, Venezuela’s crisis meant she’d wasted a year waiting for care that was never delivered. Doctors at her hospital repeatedly turned her away: The mammography machine was still broken, there were no medicines in stock, no chemicals for her blood work, no way to develop her x-rays. Uninsured and living on meager wages earned cleaning homes and baking cakes, she couldn’t afford treatment at an expensive private clinic.

In November 2016 she buried her grandmother, who had died from untreated cancer. This January after a woman in Díaz’s extended family died, also from untreated cancer, child protective services took her year-old baby away. Díaz was stricken by the fear that the same thing would happen to her children if cancer ended her life too, so she decided to act.

“I never believed in this before,” she says of spirit-medium healing. “But that day I stood up and said, ‘I’m afraid, but I’m going to go, to see what happens.’ ”

According to Guidice, “Patients arrive with different kinds of sicknesses: heart problems, spine problems, cancer, problems with their leg, knees, and eyes. There are many poor people suffering.”

In the mountains outside Guatire, Guidice channels the spirit of a venerable chieftain named Mara and uses tobacco smoke and a mixture of herbs to treat the knees of Rómulo Fuentes. Photograph by Meridith Kohut, National Geographic

Weeks after seeing Guidice, Díaz said the pain in her breast had subsided. She felt more energetic. But because it had taken so long for the cigar ash to whiten up, Guidice told her she’d need at least two more sessions. No longer a doubter, she’s committed to the process. “Knocking on this door, there can be help that one cannot see,” she says. “It’s like the wind—you can’t see it, but you can feel it.”

In Petare, a large slum in Caracas – lines of eager patients form early each morning along the “Callejón de los Brujos" or "Alley of the Witches”, a street lined with spiritual clinics where mediums channeling spirits of the courts of Maria Lionza tend to the sick.

Generations of Venezuelans have turned to the cult of María Lionza for it’s healing power, however religious leaders say never before have they experienced a boom like they have since the crisis began. No national statistical data is kept to know exactly how much the increase has been, but all spiritual healers surveyed by National Geographic say they have seen a significant increase in patients, ranging between 30% to 200% each, respectively – they say their patients are primarily working class people turned away from public hospitals, who do not have the financial resources to travel outside of the country for medical attention.

Widely sought-after shaman, Carlos Márquez, who channels the spirit of “El Guayanes” said they have seen a significant increase in patients in the past year. They now average 40-50 patients each weekday, and 60-80 on the weekends. To keep the long lines outside his door organized, he started handing out wooden squares with thick black numbers scrawled on them.

PILGRIMAGES OF HOPE

A steady stream of followers arrive daily at the riverside high altar to María Lionza at Sorte mountain, in Yaracuy state, in the Venezuelan interior. Some come crawling on their knees, an act of devotion; others like Oseas Ríos, a patient with kidney failure who had gone 15 days without his medicine because of shortages, are too walk on their own must be supported by family members.

Ronald Cárdenas traveled for three days by bus to Sorte from Santa Elena de Uairén, near the Venezuelan border with Brazil, desperate to be healed of a stomach illness that doctors in his hometown were unable to treat.

In a clearing along the riverbank, to the pounding rhythm of bongo drums and chants of “Fuerza! Fuerza!” a medium Richard Perez channeling the spirit of an ancient Viking slashed his tongue with a razor blade and broke a glass over his head. He then declared that Cárdenas was suffering from a parasite infection.

With blood streaming down his face and chest, the medium dug his fingers into Cárdenas’s abdomen. He worked his hands upward, applying pressure, then constricted Cárdenas’s his neck until he vomited. Out came two white worms about two inches long.

Farther up the river, university student Carla Gómez floated on her back in a pool of water at an altar dedicated to José Gregorio Hernández, a Venezuelan doctor who practiced medicine in the early 20th century. Hernández became a folk hero for treating poor patients for free, often buying their medicines for them with his own money. Followers of the cult of María Lionza, and devout Catholics alike, have prayed to Hernández since his death 1919, and it is widely believed that invoking his name can bring patients miraculous healing.

Gómez suffers from chronic fatigue and struggles to get out of bed each morning. Unable to find the medicine she needs because of all the shortages, she decided to make the journey to Sorte mountain to ask the spirit of Dr. Hernández to heal her.

The water pools at Sorte Mountain are believed to have powerful healing capabilities. Photograph by Meridith Kohut, National Geographic

IMPROVISATION—AND A DOSE OF FAITH

One day in the mountains outside Caracas, in a small concrete-block room that shares a wall with a pigsty, spirit medium Henry Ruíz attended to Belkis Amalia Ramírez.

Invoking the spirit of José Gregorio Hernández, Ruíz’s eyes rolled back in his head as he inserted scissors into the vagina of the 40-year-old housewife, who was lying on an overturned refrigerator that doubled as a gurney. Minutes later he extracted what appeared to be a malignant tumor from her uterus.

“I feel much better, relieved I no longer have that in my body,” she said. “What happened was a miracle.”

His next patient was suffering from chronic weakness – Henry cut a slit in her naval and sucked a small jar full of blood and brownish liquid from her stomach with his mouth - his white beard was stained red by her blood by the time he finished.

At the José Gregorio Hernández General Hospital, named in honor of the beloved saint in western Caracas, doctors struggle valiantly to treat patients despite the dearth of most medicines and supplies.

For doctors and nurses working under such conditions, similar in ways to practicing medicine on the battlefield medicine, low morale is tempered by faith. Altars to Dr. Hernández grace each floor of the hospital. In the maternity ward – photos of babies and their tiny socks pile up alongside handwritten notes of gratitude to the saint for healthy births. Maria Franco, 21, rocked her two-month-old son, Santiago as tubes drained fluid from his lungs. Ms. Franco said she brought her son to the hospital four times, and each time doctors misdiagnosed his illness as just allergies, but when his condition worsened, she prayed at the altar down the hall. Then an actor, dressed as Dr. José Gregorio Hernández came to visit to cheer up patients, and she believed it was a sign. “When he came in, I was surprised because he was identical,” she said. The actor prayed with her, then the same day doctors correctly diagnosed Santiago’s health problem – pneumonia in both lungs, and started treatment. Ms. Franco believes Santiago could have died in two days had they continued to not realized his lungs were filling with fluid, and believes it was the spirit of Dr. José Gregorio Hernández that answered her prayer and is responsible for her son being alive today.

Mariana Vargas arrived to the Emergency Room in the middle of the night, desperate - with her 52-year old, unconscious mother in her arms. Her mother, Belkis Vargas, suffers from high blood pressure and the family had scoured pharmacies, yet been unable to find the medicine she needs. After four months without taking her pills, Belkis began fainting every few minutes. Mariana carried her through the streets, taking the subway, as she drifted in and out of consciousness. She was turned away by three hospitals claiming it was impossible to admit her mother because they lacked the necessary supplies, before arriving to Dr. José Gregorio Hernández General Hospital. “This is total chaos, there is no medicine,” she said. “I thought she was going to die in my arms.”

“The faith that we have in Dr. José Gregorio Hernández is responsible for a large percentage of the patients that are saved here,” said ER nurse Rosiris Orozco. “Often we have nothing to treat them with—no antibotics, not a single pill—but the patient will leave here walking and well, thanks to God and Dr. Hernández.”

When three men injured in a motorcycle accident stumbled into the emergency room in the early morning hours one Saturday, doctors leaped into triage mode as the men groaned in pain, clutching bloody white t-shirts to gaping cuts on their faces.

“Please, can you give me something for the pain?” one pleaded, only to be told there were no pain medicines in the hospital. Nor were there any chemicals to develop the men’s X-Ray scans, so doctors snapped photographs of digital scans with their cell phones to determine the extent of internal injuries and to serve as guides while they were operating.

Scans showed fluid accumulating in the chest of one of the men, but there was no way to drain it. A medical resident quickly improvised, concocting a chest tube out of a plastic juice bottle and plastic tubing.

Meanwhile someone arrived with a broken leg—but there was no running water to mix the raw material to sculpt a cast. Another resourceful resident sent for water to be fetched from a garbage can in a nearby hallway that was collecting leakage from the hospital’s broken filtration system.

Bare shelves tell a grim story in Silvia Limardo’s pharmacy, which was previously considered one of the best stocked in Caracas. Now it’s hard or impossible to find more than 85 percent of such essential medicines as antibiotics and drugs for pain, allergies, epilepsy, and hypertension. Photograph by Meridith Kohut, National Geographic

The government of Venezuela denies that the healthcare crisis exists, and has repeatedly refused offers of international humanitarian aid. They refuse to make epidemiological reports available to the public, and allow gangs of armed government loyalists, called colectivos to occupy public hospitals, where they threaten and intimidate doctors, patients, and local journalists that speak out about critical hospital conditions.

With the government’s refusal to acknowledge the crisis, the Venezuelan healthcare crisis will most likely continue. Leaders of the cult of María Lionza say their religion is not political, but that it will continue to help all the patients that come to them searching for healing.

They have plans to build large gardens of medicinal plants at the base of Sorte mountain, and to encourage followers to practice their religion by carrying out acts of kindness toward needy patients instead of buying flowers and fruits to place on their altars.