U nder the soft orange glow of a street light in the guerrilla controlled town of Arauca, Northern Colombia, animal like silhouettes sit in puddles of water on the broken pavements. A frenzied rustling of rubbish bags, sees further shadows emerge from nearby alleyways to join them. Venezuelan families are feeding.

Venezuelan president Nicolas Maduro feasts on steak dinners in exclusive restaurants while families in Venezuela eat from bins to survive. Communications minister Jorge Rodriguez’s comment in Ecuadorian newspaper El Comercio that “there is no humanitarian crisis in Venezuela, it’s false and it’s rubbish” shows the delusional rhetoric of a government in denial.

Nazareth Pirloiria, 27, sits outside her makeshift home near an overpass at Carcelen bus terminal in Quito. She waits patiently for public food donations from passersby; the blue plastic sheeting whips and cracks in the stiff morning breeze. She has walked 20 days through Colombia with her partner and her three young children, arriving penniless, hungry and exhausted. “We had to leave, there were no food or medicines available,” she says. “We starved for a whole week only eating green plantain skins which made us all sick.”

In a report, Alfred de Zayas, a UN human rights expert, said the crisis in Venezuela is economic, not humanitarian. The consequence, however, of this economic meltdown is a humanitarian crisis on an immense scale with the 2.6 million Venezuelans who have fled forced to lock the shutters and doors on the homes they cannot sell.

Venezuela is a wealthy country with the largest oil reserves in the world, estimated at around 300 billion barrels. But crippling hyperinflation is pushing the cost of household basics like rice to as much as three times an average monthly salary per kilogram. Mothers sleep overnight outside supermarket doorways to be first in line in the morning to have any chance of buying what food and household essentials they can afford from the half-empty shelves. Extreme shortages of food have meant that on average 75 per cent of Venezuelans have lost 11kg in bodyweight.

Nazareth Pirloiria and her partner and children walked for 20 days through Columbia to get to the Carcelen bus terminal, where they are now living in a makeshift shelter (Padding Dowling) (Paddy Dowling)

At the Department for Migration in Quito, Jomir, a former director at a public school in Venezuela, recalls having to certify the deaths of at least 30 children, from newborn to three-years-old, as a result of acute malnutrition. “Mothers did not have sufficient food to be able to breastfeed their babies, that and an inadequate supply of formula milk available meant there were so many hungry babies.” She sits back in her chair and her eyes fill with the emotion she has tried so hard to suppress.

Alex Moncada, country director at CARE Ecuador, explains: “The crisis in Venezuela will continue to cause the large-scale migration we are witnessing right now. Venezuelans forced by hunger, violence and lack of opportunities for a dignified life face stigma and discrimination in countries where local communities are also living on the threshold of poverty.”

Some two years ago, professionals and the middle class spilled over the borders into Venezuela, lapping up all the good jobs. Meanwhile, the exodus of the working class sees street vendors at every traffic light in Colombia, Ecuador and Peru.

Jesus Bolivar, 29, hands out bolivares with purchases of lollipops in Quito to support his family back home (Paddy Dowling)

Refugees arrive at the Rumichaca border crossing between Ecuador and Colombia, bewildered, emotional and exhausted, some of them walking the entire length of the country dragging and carrying what contents they could fit into makeshift luggage and bin bags. The “walkers”, as they are known, have trekked 20 days and 1,400km down through the mountain roads of El Paramo de Berlin, where 4,200m above sea level temperatures at night plummet to -15C.

Pedro Gomez, 50, proudly thrusts his Venezuelan passport through the bars of the steel barriers that herd them through the Colombian border control like cattle. “Why is nobody helping us? Why is no one here to see this?” Pedro’s family were one of the many that were forced to eat from bins to survive due to the scarcity of food. “Venezuelan immigration officers at security checked our bags and stole everything from us, money, medicines and jewellery. They are meant to help us… our own people.”

Bethzaz Roca, 23, an architecture graduate, sits on a bench at Rumichaca soaking up the last of the evening sun while she waits for a bus to take her to Quito. Like many other young Venezuelan women fleeing the crisis in their country she is vulnerable to xenophobia, becoming a victim of sexual harassment, gender-based violence or even trafficking.

Like many other women fleeing the crisis, 23-year-old architecture graduate Bethzaz Roca has been subjected to xenophobia, sexual harassment and gender-based violence (Paddy Dowling)

Outside Extacy’s 2, a brothel on the back streets of Machala, near the Peruvian border town of Huaquillas, owner Ricardo sits in a loose striped shirt pitched over his large stomach, his cheap cologne filling the evening air. “Venezuelan girls are the flavour my clients want,” he says. He greets clients with a handshake, the array of gold bracelets on his wrist dancing.

Upstairs behind the door to bedroom 11 four Venezuelan prostitutes tell me how desperation, coercion and trafficking led to them servicing the hot sweaty Ecuadorian men that file out of the bedrooms, rearranging themselves as they walk back down the stairs.

The girls perch on a damp, stained floral bedspread, next to which is a small bin overflowing with used wipes and condoms cascading onto the white tiled floor. Under the fusion of red and fluorescent strip lights, Victoria, 27, a Venezuelan single mother, breaks the silence.

Victoria worked as an air hostess for a Venezuelan airline which went into administration during the economic collapse. She replied to a job advert for a Colombian airline and travelled to Cucuta for the interview, except there was no airline and there was no job, at least not as an air hostess. She found herself in the unimaginable horror of being tricked into prostituting herself to send money home to support her parents and three-year-old daughter.

Venezuelan Refugee Crisis: in pictures Show all 23 1 /23 Venezuelan Refugee Crisis: in pictures Venezuelan Refugee Crisis: in pictures One of the many children that have left their homes in Venezuela and seek temporary accommodation on their journey south. In Bogotá, Columbia this Informal Tented Settlement close to the central bus station is now home to several hundred refugees Paddy Dowling Venezuelan Refugee Crisis: in pictures People leave Venezuela carrying their worldly possessions and enter Columbia filing past on the bridge at Cúcuta. At the height of the crisis this August up to 40,000 were crossing each day Paddy Dowling Venezuelan Refugee Crisis: in pictures Katiuska Rodriguez, 30, left three children back in Venezuela and stands at traffic lights with her life story on a cardboard sign in Quito begging for donations Paddy Dowling Venezuelan Refugee Crisis: in pictures Kevin Reynold, 11, walked and hitchhiked with his family for 21 days to reach Quito, Ecuador. They arrived penniless and exhausted. CARE Ecuador through there delivery partners ADRA Ecuador are able to offer shelter, food and psychosocial support Paddy Dowling Venezuelan Refugee Crisis: in pictures Jesus Hidalgo, 21, walked 20 days through Columbia arriving hungry and exhausted. “The Columbian people were very kind to us he said.” Paddy Dowling Venezuelan Refugee Crisis: in pictures Ruth Santos 52, arrives with her husband and their two children at a shelter in Quito operated by the ‘People for Venezuela’ group and supported by CARE Ecuador. When CAREs delivery partner ADRA Ecuador welcome her she breaks down with emotion Paddy Dowling Venezuelan Refugee Crisis: in pictures Yolanda Mendez 27, from Puerto de la Cruz in Venezuela, left her husband and child to find work in Ecuador ahead of their arrival in the coming months. She is one of many mothers leaving their children behind with partners or relatives in order to support them Paddy Dowling Venezuelan Refugee Crisis: in pictures Streams of people leave Venezuela reach the midway point on the bridge entering Columbia at Cúcuta. The first round of immigration checks to see if they had the Andean card or passport stamped. At the height of the crisis this August up to 40,000 were crossing each day Paddy Dowling Venezuelan Refugee Crisis: in pictures Jesus Bolivar, 29, worked in Quito to support his family back home, he handed out Bolivares the defunct Venezuelan currency for free with purchases of lollipops “Take which ever note you want, its completely worthless”. Venezuelan Refugee Crisis: in pictures Victoria 27, was tricked into prostitution. She has suffered gender based violence, rape and has been stabbed. Such is the vulnerability of so many Venezuelan women trying to find ways to work and send money home to their families. Paddy Dowling Venezuelan Refugee Crisis: in pictures Hender Mendez Diaz, arrives with his wife and their two children at a shelter in Quito operated by the ‘People for Venezuela’ group and supported by CARE Ecuador. He worked for PDVSA the Venezuelan Oil company for 26 years and was dismissed for joining a demonstration with 20,000 fellow employees objecting to the restructuring plans. He received no pension and no medical support for him or his family Paddy Dowling Venezuelan Refugee Crisis: in pictures Maria Isabella 7, stood at reception with her mother at the Foundation of Migrant Attention in Bogotá, Columbia. After resting at the shelter for five days, and with their worldly possessions in two plastic bags, their journey to Ecuador continues. Sister Teresina hands Maria Isabella, 7, a bear for her to take and she replied “Thank you sister, this bear is the only thing I have in the world, I will look after him” Paddy Dowling Venezuelan Refugee Crisis: in pictures Streams of people leave Venezuela and enter Columbia filing past on the bridge at Cúcuta. At the height of the crisis this August up to 40,000 were crossing each day Paddy Dowling Venezuelan Refugee Crisis: in pictures David Santos 8, arrives with her family at a shelter in Quito operated by the ‘People for Venezuela’ group and supported by CARE Ecuador Paddy Dowling Venezuelan Refugee Crisis: in pictures Gilberto Gomez 39, arrived at Rumichaca with his brother Pedro. They has managed to sell what possessions they could from their homes for a fraction of their value and purchase bus tickets to get them to Ecuador Paddy Dowling Venezuelan Refugee Crisis: in pictures John Hydro Fernandez 21, has not eaten properly for 3 years living in Venezuela. He now lives at an Informal Tented Settlement in Bogotá, Columbia, close to the central bus station which is now home to several hundred refugees. He has had fever for five days and does not have the money to see a doctor, he wept from the pain. Paddy Dowling Venezuelan Refugee Crisis: in pictures Kare Angely 4, sits on top of her mothers suitcase huddled in a blanket to shield her from the freeing cold temperatures at Rumichaca border crossing on the Columbian side. Sofia her mother couldn’t stay in Venezuela any longer as there was no food for the children Paddy Dowling Venezuelan Refugee Crisis: in pictures Venezuelan’s queued late into the night in Ecuador at Rumichaca on the border. The lucky few will have a seat on this bus destined for Huaqillias on the Peruvian border Paddy Dowling Venezuelan Refugee Crisis: in pictures Richard Villaneuva, 18, walked and hitchhiked for 20 days through Columbia. He was one of a large exodus of single men leaving Venezuela alone rather than in groups as they felt they had more chance in being able to hitch a lift Paddy Dowling Venezuelan Refugee Crisis: in pictures Venezuelan’s pass through Columbian migration at Rumichaca, they exit through metal barriers herding them through like cattle. The temperature drops to 5 degrees Paddy Dowling Venezuelan Refugee Crisis: in pictures Jhoan Cedeno 24, walked and hitchhiked for 19 days through Columbia arriving hungry and exhausted. “I need to find a job to be able to send some money home for my father who is unwell, It is difficult to find work here.” Paddy Dowling Venezuelan Refugee Crisis: in pictures Bethzaz Roca 23, an architectural graduate, sits on a bench at Rumichaca in the last of the evening sun whilst waiting for a bus to take her to Quito. She hope to be able to use her degree to find a good job but has concerns about xenophobia living in Ecuador as a Venezuelan Refugee. Paddy Dowling Venezuelan Refugee Crisis: in pictures On the Columbian border of Arauca, where hostility hung in the air with the humidity. Prostitutes sit waiting for clients in one of the 15 brothels in the town. Girls are recruited into the industry as young as fourteen or fifteen years old. Paddy Dowling

Victoria looks to the floor, her eyes heavy with sadness. She explains how at times she fears for her life, and was once stabbed for resisting rape by a client in the back of a taxi as she tried to escape.

Karina Bravo at Plaperts, in partnership with CARE, runs workshops designed to specifically educate both men and woman to maintain a high standard of safety and hygiene in the sex industry. Participants, the majority of which are Venezuelan, receive entitlement to free healthcare services geared specifically towards sex work.

Venezuelan prostitutes are a third of the price. This lower tariff ensures that the market for prostitution is now more accessible to a larger clientele. Reports from Colombia’s busiest border town, Cucuta, is reporting a significantly higher number of cases of HIV and Aids.

Victoria is one of many women who was tricked into prostitution and is now stuck in one of the border towns (Paddy Dowling)

Karina has fought tirelessly for the rights of prostitutes here and has repeatedly challenged brothel owners, receiving death threats as a consequence. She knows all the working girls in Machala, and interacts with them playfully, with an exuberant joie de vivre and a sassy style to which they connect. Karina was once a prostitute herself, and understands the girls she helps – her layers of experience is part of the reason she is so successful and so well respected.

In Bogota, Colombia, an informal tented settlement close to the central bus station is now home to several hundred refugees. Under the shade of trees, men in suits slither between the black plastic sheeting of makeshift tents, casually and openly discussing buying women for sex. “I need six young girls tomorrow, my clients are waiting, I have been good to you so don’t let me down.” Sister Teresina at the Foundation of Migrant Attention, a Catholic organisation in partnership with CARE, voiced her concerns about vulnerable Venezuelan women living in camps… and the proof is clear. Families of refugees desperate for shelter are not permitted to sleep on the streets or any public places, so they are forced to find alternatives. The foundation has been quick to respond to the needs of the refugee crisis and has repurposed offices into dormitories accommodating 43 people, because “the shelter can only be used for five days, just so they have enough time for them to heal in their body and in their hearts”. A mother and daughter stand at the reception, their worldly possessions in two plastic bags. Today their journey to Ecuador continues. Sister Teresina hands Maria Isabella, 7, a cuddly bear and she replies: “Thank you sister, this bear is the only thing I have in the world, I will look after him.”

Around 15 brothels have popped up in the town of Arauca since the start of the crisis, their prices reduced, recruiting girls as young as 14 or 15 years old (Paddy Dowling)

On the Colombian border of Arauca, where hostility hangs in the air with the humidity, driver Carlos Gomez, 33, says: “Everyone is involved in everything, even me. I take young girls to executives from oil companies, sometimes they are no more than 15 years old, maybe younger, but I can’t say no.”

Carlos pays $200 (£151) per month for the protection of his 10-year-old son. “Saying no in Arauca, a cartel guerrilla-controlled territory, will cost you your life. They print your name in the paper before they kill you.” Nobody is exempt from paying guerrilla protection money here in Arauca, or the “vaccine” as it is referred to, not even British photojournalists.

The corruption and rot in this humanitarian disaster run from the president right down to the human traffickers, brothel proprietors, contraband smugglers and taxi drivers. Everyone is bending rules and taking a cut. Venezuela’s people, meanwhile, are on their hands and knees eating out of bins while the world does precious little to help. They have been let down by their government, forced to leave behind their country, their homes and their children.

NGOs like CARE work tirelessly and have recently begun distributing food and other essential items, as well as legal and psychosocial support, in four localities: Apure (Venezuela), Arauca, Ipiales, Tulcan and Quito. They will continue mobilising resources to address the needs of the refugees and the host communities, promoting integration and an enabling environment to address xenophobia and exploitation, with local governments.

This crisis demonstrates an entrenched, overwhelming hopelessness, based on social betrayal and the ill-treatment of women becoming normalised. Every face, every expression shows hopelessness on an overwhelming scale. The world must not look away; for Victoria’s sake in Machala, let down by so many but still fighting for a better life.

With continued support from private donors and expected support from institutional donors, CARE will change and empower the lives of the most vulnerable and marginalised.