A large hospital in Valencia gets the New Yorker treatment this week, at the start a long piece by William Finnegan that’s hard to do justice to with a quote or two.

It starts as what you think will be just another hospital exposé, in the tradition of Hannah Dreier’s scraped-knee-that-almost-killed-your-kid or Meredith Kohut and Nick Casey’s psychiatric hellscape. But then Finnegan does something interesting: instead of zeroing in on the brutal human toll of a collapsed hospital system, he treats the hospital as a kind of metaphor for the Venezuelan state writ-large.

We circled the hospital grounds, following a tin-roofed walkway. It was a dim, greasy day, raining lightly. We came upon a long, narrow encampment: families who had strung hammocks between the posts of the walkway or laid mattresses on the concrete, out of the rain. There were bags, baskets, baby strollers. People seemed to be camped long term.

José said that he had raised the forty dollars for the tests, partly by begging on buses, after losing his job.

A dark-skinned man in a hammock said that he had been there for three months. His four-year-old son was in the hospital with a low blood-platelet count. “Viral infection,” the medical student told me. “Maybe Zika, or dengue. If he gets the right meds, he’ll survive.” He asked the man, whose name was José, about blood tests. José said that he had raised the forty dollars for the tests, partly by begging on buses, after losing his job. Now he needed money for medicines, none of which the pharmacies had in stock. “We must buy from the mafia,” he said. He meant the black market, but not just the ubiquitous profiteers known as bacha­queros. The medical student understood. Some of the security forces that were deployed, or self-­deployed, to the hospital were in the medical-­supply business.

The overstaffed entrances—all the military and police uniforms and firepower—began to make more sense. Cops and soldiers, militares, were notoriously underpaid. There was money to be made here. We talked to other families camped on the walkway, and on concrete benches under an awning closer to the hospital buildings. Some people were surprisingly outspoken. They denounced the prices charged for examinations (in a system of supposedly free health care), the corruption, the intimidation, the outrageous prices for sterile gauze, saline, food (when there was food), and medications. Some militares had the nerve to accuse the families of profiteering, and to seize their hard-won supplies when they tried to enter the hospital. These were items that, often, they had bought from other militares, who had looted them from pharmacies, or from shipments meant for hospitals. The worst actors were the colectivos, gangs of barrio toughs armed by the government and deputized as “defenders of the revolution.” Their main activity, as runaway inflation and food rationing gripped the country, was shaking down and monitoring their neighborhoods, but they found opportunities around hospitals and seemingly answered to no one. (Some colectivos could trace their descent to urban guerrillas from the sixties who had never disarmed.)

The long piece then broadens out into a more conventional, though very well executed, #TropicalMierda update. But that bit from the hospital in Valencia…man!

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