A new study finds Venezuela on the brink of famine, with an alarming fifteen percent of citizens saying they can only feed themselves with “food waste discarded by commercial establishments,” while nearly half say they have had to take time off work to search for food.

The study — conducted by More Consulting and published in the Spanish-language Diario de las Américas — reflects a reality that has become the signature of President Nicolás Maduro’s tenure: a food and medicine shortage that forces most in the nation to wait in supermarket lines that can last up to eight hours. On many occasions, after the wait, they find that there is nothing left to buy.

The More Consulting study found that three out of every four Venezuelans (72 percent) was unable to feed themselves an optimal diet of breakfast, lunch, and dinner. 24.2 percent say they rarely eat protein, living off of local tubers like yuca and malanga and some fruit. More than half of Venezuelans (52.3 percent) buy their foods through the black market, from private individuals who have stocked a surplus of an item they need.

53.9 percent of Venezuelan respondents said they had gone to bed hungry, 48 percent say they have been forced to take time off work to scrounge for food.

The numbers align with previous surveys taken earlier this year, following the declaration of a “nutritional emergency” by the Venezuelan National Assembly in February. In June, The New York Times cited a poll by Simón Bolívar University finding that nearly 90 percent of Venezuelans did not have the money necessary to buy food for three full meals a day. The Times estimated then that an average of 50 violent incidents involving supermarkets, food cargo trucks, or other food sources had occurred within a two-week span of time.

President Maduro implemented a socialist ration system in April 2014, in which Venezuelans were prohibited from buying more than their rations books allowed, even when the nation’s bolivar currency was not struggling with the current 700 percent estimated inflation rate. Today, Maduro has ordered police and military units to crack down on anyone attempting to buy more than their allotted rations, hoarding food, or waiting outside a supermarket during hours in which the store is not open.

According to the Washington Post, Venezuelan police have arrested “at least 9,400 people this year for allegedly breaking laws against hoarding, reselling goods or attempting to stand in line outside normal store hours.” To make the arrests more efficient, the police have used a bus that drives from market to market in the early morning hours, looking for loiterers. Anyone found attempting to wait overnight in front of a supermarket is arrested.

Maduro has also ordered the military to control the nation’s food supply and created Socialist Party committees known as Local Committees for Supply and Production (CLAP) to designate who in each neighborhood receives food. Opposition members have accused CLAP leaders of discriminating with food supplies against those who have publicly opposed the government.

Maduro himself has appeared little at ease in public regarding the impending famine in his country. Earlier this week, Maduro made a joke using the country’s new euphemism for starvation, “Maduro’s diet,” telling a Socialist Party member on live television that his diet “makes you hard, no need for Viagra!”

When appearing at public events, however, Maduro has been increasingly targeted by hungry protesters. During a visit to the island of Margarita earlier this month, a mob surrounded Maduro, banging pots and pans in his face and yelling, “We are hungry!”

Maduro has had to crack down on Margarita island as it is currently hosting the summit for the Non-Aligned Movement nations, described by the Pan-American Post as a group of “120 member countries across all continents that do not align themselves with or against any major power bloc.” Despite the group’s size, this year’s summit is proving significantly unpopular. The only heads of state currently slated to attend are Zimbabwe’s Robert Mugabe, Cuba’s Raúl Castro, Bolivia’s Evo Morales, Ecuador’s Rafael Correa, and Iran’s Hassan Rouhani.