In this Feb. 12, 2016 photo, a municipal worker fumigates for the Aedes aegypti mosquito that transmits the Zika virus, in the Petare neighborhood of Caracas, Venezuela. Preventing the Zika virus' spread in the absence of a public campaign in a Venezuela where the health care system is near collapse means the people most at risk, the poor, don't even know about the epidemic. Chronic shortages have left the country without insect repellent or contraceptives, leaving women unable to guard against pregnancy, not to mention sexual transmission of the virus. (AP Photo/Fernando Llano)
CARACAS, Venezuela (AP) – This is what the Zika outbreak looks like in Venezuela, a country whose medical system has teetered for months on the brink of collapse:
There's a lack of bug spray to prevent mosquito bites, scant contraceptives to avert pregnancies, little medicine to treat Zika-linked maladies. There has been no effective public health campaign to inform the public about the disease — and nobody really knows how many infections there have been.
"It's just terrible what we are living," said Carla Natera, a 50-year-old local government worker who contracted Zika and spent three days searching pharmacies for an ointment to calm the angry rash that broke out on her face and body.
William Barrientos, a doctor and opposition lawmaker, says the socialist government is not equipped to confront a health crisis in a country where food and medicine shortages are acute, the economy is a shambles and a political crisis deepens by the day.
"There is no education and information campaign among the population here," and no tracking of the mosquitoes that carry the virus, he said.
The scale of what Venezuela is going through is unclear. Officials alerted the World Health Organization to the first case of Zika here in November but did not release statistics or reach out to the public until two months later.
The Health Ministry is now reporting more than 5,000 suspected Zika cases and three related deaths.
But a network of independent physicians allied with the opposition — the Venezuelan Society of Public Health — says that's likely a dramatic underestimate. It says a polling of local health officials found a rise in acute fevers that could correspond to 400,000 Zika cases, and the outbreak will likely reach its peak around the end of March.
Neighboring Colombia, by contrast, has reported more than 30,000 cases.
It's been a year since the government published up-to-date epidemiological data and reaching the Health Ministry for information is frustrating. The main line for hits "Zika situation room" was out of order Tuesday and the person answering another number for the room hung up twice on a reporter.
To compensate for the lack of official figures, doctors have been turning to informal surveys, social media and even Google analytics to try to get a handle on the scope of the outbreak.
The virus has been linked to a spike in Guillain-Barre, a rare disorder in which the immune system attacks the nervous system, causing temporary paralysis that can be fatal. Health officials say the country has seen 255 cases of the Guillain-Barre syndrome since the Zika outbreak began — a much higher incidence than reported in other countries grappling with the virus.
"Normally, we'd expect 30 or 40 cases of Guillain-Barre a month," said former health minister José Félix Oletta. "What this shows is that the minister has the total number of Zika cases wrong. It's much higher."
Venezuela's medical shortages could easily boost the mortality rate for Guillia-Barre, which is about 5 percent in developed countries. Nancy Pino, a 68-year-old retired school administrator, died last month of Guillain-Barre that developed after she fell ill over Christmas with symptoms of Zika.
Doctors said the woman from the lowland state of Anzoategui needed intravenous immunoglobulin therapy, and sent her three children on a frantic two-week search for the medicine after they rushed her to Caracas.
As the family begged for immunoglobulin at state agencies, on local television channels and even at the presidential palace, their mother lost the ability to walk, speak, open her eyes and, finally, to breathe.
"They shut the doors on us. There's just not medicine here," daughter Nehara Ramos said.
The country's private, opposition-leaning pharmaceutical association says Venezuela only has 20 percent of the medications it requires, a result of currency and price controls.
The government blames the shortages on "economic war" waged by its right-wing opponents.
Earlier this month, Health Minister Luisana Melo invited sick Venezuelans to email requests for medicine to a state-run Gmail account. Last week, President Nicolas Maduro said the country had received a special shipment of drugs that will be sufficient to combat Zika, but did not specify what the shipment included.
The Health Ministry is advising the public to use bug spray, an item all but impossible to come by in Venezuela these days, and to clean out their tubs of standing water once a week. That is a lot to ask, however, of the many Venezuelans keep tubs in their homes full of water to deal with chronic shortages.
Meanwhile, state media have been broadcasting a steady stream of footage of health officials accompanying workers on mosquito fumigation and immunoglobulin distribution missions.
What they haven't been doing with any regularity is offering the public advice on how to behave.
Venezuelan officials say the country has not yet seen any cases of birth defects associated with Zika, as have been reported in Brazil.
Other countries have advised women to postpone pregnancy until the Zika epidemic has slowed. But in Venezuela, condoms and birth control pills are in extremely short supply, making it complicated for women to avoid pregnancy.
In the western state of Zulia, a focal point of the epidemic, local health authorities say 25 pregnant women have contracted Zika and are under medical observation.
Doctors are also complaining that laboratories have been unable to obtain the chemical needed to diagnose Zika by identifying the DNA of the virus. Doctors have to rely on a clinical diagnosis based only on symptoms.
"It's like flying by instruments," pediatrician Carolina Mirabal said.
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