Alejandro Ortega's body is covered with round, dark spots. The 21-year-old's hands, arms, feet and even his face appear as though they are marked with scars that have not properly healed. "Don't worry, it's not contagious," he said, extending his arm to shake hands. 
 
 Read more: Desperate Venezuelans pouring into Brazil 
 
 Alejandro's doctor at the Venezuelan Central University clinic in Caracas explained that the spots have been caused by a fungal infection transmitted through pigeons. 
 
 "It's safe for most people, because their immune system can handle it," the doctor said. "But for people like Alejandro, who are HIV-positive and have not been taking antiretroviral drugs for months, it can be fatal." 
 
 With his emaciated body, pale face and skin covered in lesions, Alejandro is suffering as many patients afflicted with the human immunodeficiency virus (HIV) that causes AIDS did in the 1980s, before antiretroviral medication was introduced. The dark patches look like Kaposi's sarcoma, a cancer that occurs mainly in connection with HIV/AIDS and was very common among the first people infected with the virus when the global epidemic began nearly four decades ago. 
 
 "It looks the same, but what Alejandro has is, in fact, only a skin infection," said the doctor, who prefers to remain anonymous in order to avoid any problems with the government. 
 
 Read more: Colombia tightens border amidst wave of Venezuela refugees 
 
 Alejandro is one of about two dozen HIV patients who are being treated at Venezuela's largest center for the virus. Nearly all are suffering from the same problem: They have caught secondary infections because they can no longer take the drug cocktail known as highly active antiretroviral therapy (HAART). This breakthrough treatment was introduced in 2000 and prevents HIV from developing into AIDS. 
 
 The likelihood of the virus being transmitted from a mother to her newborn child can also be significantly reduced by the use of antiretroviral medication. But currently in Venezuela, such treatment is almost impossible. 
 
 "The situation that most patients are in is similar, or perhaps even worse, than it was 30 or 35 years ago," said Martin Carballo, the clinic's director. 
 
 Read more: Venezuelans facing economic crisis cross border to secure cash lifelines 
 
 The University Clinic in Caracas has put up a notice desperately calling for donations 
 
 'This is a tragedy' 
 
 Roughly two years ago, when rapidly falling oil prices transformed Venezuela's economic crisis into a humanitarian catastrophe, the government began importing fewer medicines. At first, only simple drugs were affected, then it was antibiotics and even anti-inflammatory drugs. For the last year, patients afflicted with chronic illnesses that require expensive medication have been suffering under the government's reduced medicine import scheme. 
 
 The lack of medication to treat HIV first became a problem at the end of 2016. But the situation turned critical last year, Carballo explained. 
 
 "This is a tragedy," he said. "Not being able to take the right drugs is like a death sentence for many people. We've been missing the medications in the clinic for over four months, some of them we haven't had in six months." 
 
 The doctors at the Caracas University hospital are facing an ethical dilemma. Some argue that the clinic should not accept any new seriously-ill HIV patients, because they cannot be treated. It is not just antiretroviral medication that is lacking, it's everything: From gloves and syringes, to antibiotics and painkillers. 
 
 "We have reached our limits, and we can't even help people here to die with dignity," said Maria Eugenia Landaeta, head of infectious diseases at the clinic. "We can't offer anything to the sick except the will to help and our medical expertise. We even have to ask the patients to bring drinking water from home." 
 
 The Venezuelan health system has practically collapsed amid the country's economic crisis 
 
 Nothing to work with 
 
 Another patient, named Jorge, has stopped speaking. Most of the time, his eyes are fixed on a point in the room where the sun is shining on the wall. He is covered by a thin scarf and his emaciated legs are visible, as is the adult diaper he is wearing. Jorge's face is deathly pale; his dry mouth hangs open. 
 
 "He's dying, it's all over. They've killed him," said his sister Sol Reys. 
 
 It is the third time Jorge has been hospitalized in the last eight months. When ingredients for the anti-AIDS drug cocktail became scarce, Jorge's condition rapidly deteriorated. 
 
 "He's been ill for many years and has had relapses. But now the situation is really hopeless," Sol Reys said, as she swatted away a mosquito trying to land on her brother's forehead. "Cleaning products, diapers, painkillers, food — my God, even water — I have brought in everything that Jorge has here." 
 
 The situation that Jorge and Alejandro are facing is not unique in Venezuela. Even contraceptives have practically disappeared from the shelves, or become so expensive that the average Venezuelan can no longer afford them. In 2016, the government stopped distributing condoms among the population, and the price of buying them in the pharmacy has reached 20-30 percent of the monthly minimum income. 
 
 "This is a very serious problem, there is simply no more birth control," said Nubia Laguna from Nina Madre (Mother Girl), a nongonvernmental organization that supports young mothers. "We do not know at the moment how widespread sexually transmitted diseases are in the country, because there have been no official figures on the part of the state for more than two years." 
 
 Unused medical equipment in a corridor of Caracas Teaching Hospital 
 
 'I'm still young, I want to live.' 
 
 There are dozens of people, sometimes over 100, queuing in front of the Caracas University hospital's outpatient clinic every day. 
 
 "Previously, there were five to 10 patients with suspected HIV," said Landaeta. "Today there are twice as many. Everyday." 
 
 A further difficulty is that the hospital lacks the means to carry out HIV tests. 
 
 "Hardly any Venezuelan can nowadays find out whether he or she is HIV-positive under the public health system. You have to pay extra for a test," said Davi Flora, who also works at the university hospital. "And if we don't even know whether the patient is HIV-positive and if so, how much of the virus has spread to him, we can't start treatment." 
 
 Alejandro knows he's running out of time. Without the proper medication, there's not much the doctors can do for him. 
 
 "I'm afraid of getting to a point where there's no cure," he said. This has happened in recent weeks with other patients. "I see people dying here. But I'm still young, I want to live and I know I can, with the right medication." 
 
 On his bad days, waiting for the drugs and struggling against the infection, Alejandro finds comfort in reading the Bible. His favorite verse is Jeremiah 33:6: "Nevertheless, I will bring health and healing to it; I will heal my people and will let them enjoy abundant peace and security." ||||| CARACAS (Reuters) - Yasmira Castano felt she had a fresh chance at life when she received a kidney transplant almost two decades ago. The young Venezuelan was able to finish high school and went on to work as a manicurist. 
 
 But late last year, Castano, now 40, was unable to find the drugs needed to keep her body from rejecting the organ, as Venezuela’s healthcare system slid deeper into crisis following years of economic turmoil. 
 
 On Christmas Eve, weak and frail, Castano was rushed to a crumbling state hospital in Venezuela’s teeming capital, Caracas. Her immune system had attacked the foreign organ and she lost her kidney shortly afterwards. 
 
 Now, Castano needs dialysis three times a week to filter her blood. But the hospital attached to Venezuela’s Central University, once one of South America’s top institutions, frequently suffers water outages and lacks materials for dialysis. 
 
 “I spend nights not sleeping, just worrying,” said Castano, who weighs around 77 pounds (35 kg), as she lay on an old bed in a bleak hospital room, its bare walls unadorned by a television or pictures. 
 
 Her roommate Lismar Castellanos, who just turned 21, put it more bluntly. 
 
 “Unfortunately, I could die,” said Castellanos, who lost her transplanted kidney last year and is struggling to get the dialysis she needs to keep her body functioning. 
 
 The women are among Venezuela’s roughly 3,500 transplant recipients. After years leading normal lives, they now live in fear as Venezuela’s economic collapse under President Nicolas Maduro has left the once-prosperous OPEC nation unable to purchase sufficient foreign medicine or produce enough of its own. 
 
 Some 31 Venezuelans have seen their bodies start to reject their transplanted organs in the last month due to lack of medicine, according to umbrella health group Codevida, a non-governmental organization. 
 
 At least seven have died due to complications stemming from organ failure in the last three months. 
 
 A further 16,000 Venezuelans, many hoping for an elusive transplant, are dependent on dialysis to clean their blood - but here too, resources and materials are sorely lacking. 
 
 Nearly half of the country’s dialysis units are out of service, according to opposition lawmaker and oncologist Jose Manuel Olivares, a leading voice on the health crisis who has toured dialysis centers to assess the scale of the problem. 
 
 In the last three weeks alone, seven people have died due to lack of dialysis, according to Codevida, which staged a protest to decry the critical drug shortages. 
 
 Once-controlled diseases like diphtheria and measles have returned, due partly to insufficient vaccines and antibiotics, while Venezuelans suffering chronic illnesses like cancer or diabetes often have to forgo treatment. 
 
 Hundreds of thousands of desperate Venezuelans, meanwhile, have fled the country over the past year, including many medical professionals. 
 
 Amid a lack of basics like catheters and crumbling hospital infrastructure, doctors who remain struggle to cope with ever scarcer resources. 
 
 Yasmira Castano, 40, who lost her transplanted kidney, lies on a bed at a state hospital in Caracas, Venezuela February 7, 2018. Castano was unable to find the drugs needed to keep her body from rejecting the organ. On Christmas Eve 2017, she was rushed to a state hospital. Her immune system had attacked the foreign organ and she lost her kidney shortly afterwards. REUTERS/Carlos Garcia Rawlins 
 
 “It’s incredibly stressful. We request supplies; they don’t arrive. We call again and they still don’t arrive. Then we realize it’s because there aren’t any,” said a kidney specialist at a public hospital, asking to remain anonymous because health workers are not allowed to speak publicly about the situation. 
 
 Venezuela’s Social Security Institute, tasked with providing patients with drugs for chronic conditions, did not respond to a request for comment. 
 
 “STRAIGHT TO THE CEMETERY” 
 
 Terrified transplant patients are indebting themselves to buy pricey medicine on the black market, begging relatives abroad to funnel drugs into the country or dangerously reducing their daily intake of pills to stretch out stock. 
 
 Larry Zambrano, a 45-year old father of two with a kidney transplant, resorted to taking immunosuppressants designed for animals last year. 
 
 Guillermo Habanero and his brother Emerson both underwent kidney transplants after suffering polycystic kidney disease. Emerson, a healthy 53-year-old former police officer, died in November after a month without immunosuppressants. 
 
 “If you lose your kidney, you go to dialysis but there are no materials. So you go straight to the cemetery,” said Habanero, 56, who runs a small computer repair shop in the poor hillside neighborhood of Catia. 
 
 A Reuters reporter went to the Health Ministry to request an interview, but was asked at the entrance to give her contact details instead. No one called or emailed. 
 
 Reuters was also unable to contact the Health Ministry unit in charge of transplants, Fundavene, for comment. Its website was unavailable. Multiple calls to different phone numbers went unanswered. An email bounced back and no one answered a message on the unit’s Facebook page. 
 
 Maduro’s government has said the real culprit is an alleged U.S.-led business elite seeking to sabotage its socialist agenda by hoarding medicine and imposing sanctions. 
 
 “I see the cynicism of the right-wing, worried about people who cannot get dialysis treatment, but it’s their fault: they’ve asked for sanctions and a blockade against Venezuela,” Socialist Party heavyweight Diosdado Cabello said in recent comments on his weekly television program. 
 
 Health activists blame what they see as Maduro’s inefficient and corrupt government for the medical crisis and contend that government announcements of more imports for dialysis are totally insufficient. 
 
 Despite his unpopularity, Maduro is expected to win a new six-year term in an April 22 presidential election. The opposition is likely to boycott the vote, which it has already denounced as rigged in favor of the government. 
 
 Maduro has refused to accept food and medicine donations, despite the deepening healthcare crisis. Health activists and doctors smuggle in medicines, often donated by the growing Venezuelan diaspora, in their suitcases, but it is far from enough. 
 
 In the decaying hospital and dialysis center visited by Reuters, patients clamored for humanitarian aid. 
 
 Dolled up for her birthday and surrounded by cakes, the 21-year-old Castellanos took selfies with her friends and spoke excitedly about one day returning to dance, one of her passions. 
 
 Slideshow (13 Images) 
 
 But fears for her future permeated the room. A hospital worker stopped by to wish Castellanos many more birthday celebrations but her worried face betrayed doubts. 
 
 “Other countries need to help us,” Castellanos said.
– There's a literal casualty of Venezuela's ongoing economic woes: those with kidney problems. Reuters dives into the dire situation that both kidney transplant recipients and those hoping to join their ranks face in the midst of the country's inability to buy enough drugs from abroad or make enough domestically. USA Today cites the Pharmaceutical Federation of Venezuela in saying the country was experiencing an 85% shortage of medicine—and that was as of June 2017. There are some 16,000 people who require dialysis, but the country's ability to clean their blood is waning, with an opposition lawmaker and oncologist saying only about half of the country's dialysis units are operational. Codevida, a health-related NGO, logged seven deaths in the first few weeks of February due to a lack of dialysis. But dialysis patients, many hopeful for a future transplant, aren't the only ones dying. About 3,500 Venezuelans have had kidney transplants, and that number is slowly being chipped away at as they find themselves unable to obtain the anti-organ rejection drugs they need to take for the rest of their lives. A 40-year-old woman lost the transplanted kidney she's had for nearly 20 years and is now on dialysis, though she's encountering issues there, too; a 45-year-old man is trying to hang onto his by taking immunosuppressants made for animals. In the case of two brothers who received transplants, one died in November after going a month without medicine. Says his brother, "If you lose your kidney, you go to dialysis, but there are no materials. So you go straight to the cemetery." Deutsche Welle reports HIV patients there are trapped in a similar situation.