Alexandra Álvarez can still recall the exact moment council workers arrived in her street in Petare, a sprawling neighbourhood in Caracas, to distribute food rations and found her children malnourished, sick, and with hair dyspigmentation.
“They told me they would take my children away because it was clear I couldn’t feed them anymore,” the 28-year-old told The New Humanitarian, tears streaming down her face, even though her children – now aged one, six, and eight – remain with her.
Álvarez lost her job cleaning a private office during the pandemic. Before COVID-19 struck, she received food for her children in exchange for work. But since the pandemic broke out in March 2020, she and her children, along with thousands of other Venezuelan families, have found themselves with no access to food.
Some 7 million Venezuelans – roughly a quarter of the population – are in need of humanitarian assistance as a result of their country’s decade-long economic collapse.
Álvarez, like all of them, is confronted by a litany of problems. A lack of running water, frequent power cuts, outbreaks of preventable diseases, and limited access to basic healthcare services have afflicted Venezuelans for years. As a result, everyone in Álvarez’s family is sick. She described the pain of being forced to watch her three children lose weight.
In 2019, a UN World Food Programme (WFP) assessment found that more than 9 million people in Venezuela were moderately to severely food insecure. With the pandemic exacerbating the situation, experts say this number is likely much higher today, even though there’s no real-time official data.
“With the impact of the pandemic and the economic crisis, and in the face of inflation and the decline of purchasing power of the bolívar, the national currency, the number of people facing acute food insecurity could be as high as 11 million,” Susana Raffalli, a Venezuelan nutritionist who advises Caritas Venezuela, told The New Humanitarian.
"We have had to bury them without even registering them at birth. These children passed away without an identity, wasted."
Children are especially vulnerable to hunger, and Indigenous communities seem to be at particular risk. According to the National Academy of Medicine of Venezuela, childhood malnutrition increased by 20 percent in 2021, and by 33 percent in the first half of 2022.
Kape Kape, an NGO advocating for Indigenous people’s rights, warned in July 2021 that 56 percent of Indigenous households in Venezuela now suffer from severe food insecurity. An article published by the Venezuelan NGO Acción Solidaria on 17 June said one third of children in Venezuela suffer from stunting.
The UN’s Global Humanitarian Overview for 2022 states that “food security and nutrition remain a key concern [in Venezuela], since the rate of undernourishment has increased from 2.5 percent in 2010-2012 to 27.4 percent in 2018-2020.”
Venezuela’s economic deterioration, a result of years of mismanagement and corruption, compounded by crippling economic sanctions imposed by the United States, has led to what Feliciano Reyna, the president of Acción Solidaria, describes as multidimensional poverty.
“We have a situation that, from a humanitarian perspective, affects people, takes lives and causes suffering,” said Reyna.
According to a Caritas Venezuela report, during the first months of the pandemic – between April and June 2020 – there was a 73 percent increase in levels of acute malnutrition in children under five, and a 24 percent rise in levels of malnutrition in pregnant women. Nearly half of the malnutrition cases were detected in children under two years old.
Data collected between mid-2021 and early 2022 for HumVenezuela, an online platform that monitors the population’s needs, confirmed high levels of food insecurity, limited access to basic services, including medical care and water, and worsening conditions in and access to basic education.
Among the over 20,000 people surveyed for the report – shared with The New Humanitarian in advance of publication – over 70 percent said in March that their family income was insufficient to cover their needs. Some 79.4 percent said they lacked access to enough food, while 72 percent were affected by electricity cuts or had no access at all to the grid. Similar numbers lacked regular access to water and sanitation services.
Raffalli said projections based on data collected in January by humanitarian organisations show that 135,000 children are currently facing acute malnutrition in Venezuela’s 18 poorest counties, while 285,000 are experiencing stunting. Some 200,000 pregnant and lactating women suffer from low weight acute nutritional deficit, and more than 300,000 face anaemia. According to Caritas Venezuela’s monitoring system for nutrition surveillance for children under five, the real situation could be even worse, she added.
Raffalli described how she and her colleagues have had to look after children, often infants, as they die from malnutrition. "We have had to bury them without even registering them at birth,” she said. “[These] children passed away without an identity, wasted. This has been very hard for us, but [also] for their mothers.”
For years after Venezuela’s economic collapse began in earnest in 2013, international aid was hostage to geopolitics, in particular because of tough US sanctions and Western recognition of President Nicolás Maduro’s rival, Juan Guaidó, as president.
Since 2020, Maduro’s government – which long denied the humanitarian crisis in Venezuela – has allowed UN agencies and others to step up their presence, with WFP launching a school meals programme in July 2021. It’s unclear how much progress the initiative, which aims to reach 1.5 million pre-primary children by the end of 2023, has made. Asked to update The New Humanitarian on the rollout, WFP did not respond in time for publication.
‘Children are going to hospitals to die’
Hyperinflation is down from historic highs, but rising food prices continue to put basic baskets out of reach for most. In May, the cost of feeding a family of four was put at $477.52, up 189 percent from a year ago. With the minimum monthly salary only about $28, a family would need almost 20 times as much to cover it.
Families used to rely on remittances from relatives and friends working in neighbouring countries. But most of those currencies are now so devalued that payments became nearly worthless once transferred from national currencies to dollars.
When Álvarez lost her job cleaning offices, she had no choice but to start collecting scrap metal in exchange for money. She receives one dollar in exchange for 10 kilos of metal, still not enough to feed her children. Her youngest, one-year-old Isamar, suffers from diarrhoea on a daily basis. Other than breastmilk, Álvarez has no food to offer her. Occasionally, when she cooks rice, all she can give her is rice water.
Katherine Martínez, director of Prepara Familia, an NGO that provides additional help to patients in Venezuela’s underfunded hospitals, told The New Humanitarian that most mothers breastfeed their children for much longer than is recommended because, like Álvarez, they can’t offer them any other food.
At J.M. de Los Rios, one of the main hospitals in Caracas for children and adolescents, 16 out of 34 services closed during the pandemic as doctors and nurses left the country or looked for better and safer jobs, according to Martínez. The few doctors who stayed are now left to deal with a constant stream of acute cases, including those of kwashiorkor, one of the most severe forms of malnutrition, which causes swelling under the skin in children and babies.
“As a nutritionist, the last time I saw kwashiorkor was in Guatemala in 1989, and I never thought I would see it again,” Raffalli said, adding that she has also seen cases of children suffering malarial fever and acute malnutrition. “That is terrible. I will [never] forget that.”
It is dangerous for health professionals to speak out publicly in Venezuela due to government censorship and attacks. But even though she feared for her safety, one paediatrician in the capital, Caracas, did agree to speak to The New Humanitarian on condition of anonymity.
“The cases of malnutrition we see are innumerable,” she said. “The most affected are children below the age of two, who suffer from both kwashiorkor and marasmus. The mortality rate in this age group is very high.”
Teenage pregnancy is also very common, particularly in neighbourhoods where mothers have no access to good nutrition or prenatal care. “Many of these children are born with infectious diseases, nutritional diseases, and congenital malformations, which worsens the nutritional status of the newborn and, due to economic deficiencies, also that of the mother,” the doctor explained.
Many adolescent mothers are also unable to breastfeed their babies and end up giving them foods inappropriate for their age. “Cases of diarrhoea occur, which leads to states of malnutrition and in most cases the death of children,” the doctor said. She also recalled a case in which two young children were found eating garbage and cigarette butts from a garbage dump in the capital. “It is very common today to see children with their parents eating from the garbage or in a state of severe malnutrition,” she added.
“Working as a doctor in Venezuela is very difficult. There are so many deficiencies and so much pain we see daily on all of our patients’ faces.”
Hospitals are ill-equipped for the needs of both patients and doctors, often lacking regular access even to running water, let alone basic medications.
“The shifts that resident doctors do in these institutions are usually more than 48 hours long,” the paediatrician said. “And during all that time, you cannot clean yourself and your hands, which not only affects our job, but also affects our patients.
“Working as a doctor in Venezuela is very difficult,” she said. “There are so many deficiencies and so much pain we see daily on all of our patients’ faces.”
Raffalli added that hospital equipment in Venezuela is mostly only suitable for adults – the catheters, for example, are usually too big for the children. There is typically no electricity, water, or therapeutic formulas for children. “Children are going to hospitals to die,” she said.
Government aid with strings attached
Yajaira Alejo, 43, has also been unable to feed her children in recent months. Every day, she begs for money on Solano Avenue, a main artery in eastern Caracas, hoping to collect 14 bolívares ($2.60) to purchase a state-subsidised food box known as a CLAP, the acronym for Los Comités Locales de Abastecimiento y Producción – a government programme that has become the only source of food for most families in need.
“My house was destroyed due to a landslide after a heavy rain,” Alejo, whose youngest daughter, one-year-old Elia, has Down’s syndrome, told The New Humanitarian. “I became homeless and begged for food to feed my three children.”
Alejo, who also worked as a cleaner until she lost her job during the pandemic, receives no aid or benefits. As a cleaner, she used to receive 7 bolívares per day. Today, she has no income and no food in her house. She spends her days with her children, including her disabled daughter, begging for food in the street.
“It was not intended to be food aid, but rather a subsidy to the food. People would be paying only [around] 20 percent of the price they would pay in a shop,” Raffalli explained. “It is an inefficient and ineffective way of using social protection to [protect] food security.”
The programme – widely criticised for overcharging and under-delivering – has been entangled in corruption allegations, with the president’s allies accused of stealing hundreds of millions of dollars.
Around 10 CLAP consumers contacted by The New Humanitarian in different districts around the capital said the food in the boxes was insufficient – mostly low quality rice, flour, pasta, sugar, tuna cans, oil, and mayonnaise: none of which is suitable for children and babies.
“This whole street is full of people who started begging for money after the pandemic because they have no other choice.”
“Although they promise to be more affordable, prices vary in each community, which generates discontent among those who receive this benefit,” explained Jennifer Jardim, a legal support coordinator at Acción Solidaria. “The frequency of delivery of the CLAP programme [also] varies.” But given the high price of food, most Venezuelans rely almost exclusively on the CLAP boxes, Jardim added.
The assistance is politicised too. The delivery of the CLAP boxes is typically managed by community groups that support the government party, so people who attend anti-government protests can find themselves without any benefit.
And for the most vulnerable, CLAP boxes are still only an occasional luxury, despite their heavily subsidised prices.
“I ask for money in the church; sometimes, a local shop owner gives a sandwich to me and my daughters. It can take me days to collect 14 bolívares,” Alejo said. “This whole street is full of people who started begging for money after the pandemic because they have no other choice.”
With reporting support from Rosali Hernández and Franci Sánchez. Edited by Paula Dupraz-Dobias.