What our country is going through is monstrously unique: It’s nothing less than the collapse of a large, wealthy, seemingly modern, seemingly democratic nation just a few hours’ flight from the United States.

In the last two years Venezuela has experienced the kind of implosion that hardly ever occurs in a middle-income country like it outside of war. Mortality rates are skyrocketing; one public service after another is collapsing; triple-digit inflation has left more than 70 percent of the population in poverty; an unmanageable crime wave keeps people locked indoors at night; shoppers have to stand in line for hours to buy food; babies die in large numbers for lack of simple, inexpensive medicines and equipment in hospitals, as do the elderly and those suffering from chronic illnesses.

At 14 years old, Maikel Mancilla Peña had been battling epilepsy for six years. His condition was under control, just about, thanks to a common anti-convulsive prescription drug called Lamotrigine. It had long been a struggle for his family to get it, but as the gap between the real cost of the drugs and the maximum pharmacies were allowed to charge for them grew, it became impossible to find them.

On February 11th this year, Maikel’s mom Yamaris gave him the last Lamotrigine tablet in their stash. None of Yamaris’s usual pharmacies had any anti-convulsants in stock. She worked social media— which in Venezuela these days is filled with desperate people trying to source scarce medicines—but no luck. She drove hours to track down a lead, but came up empty-handed.
In the following days, Maikel experienced a series of increasingly violent epileptic seizures, as his family watched helplessly. On February 20th, he suffered respiratory failure and died.

Maikel’s case is not unique. The collapse of the health-care system and the scarcity of medicine is costing lives every day. Psychiatric patients struggling with schizophrenia have to go without anti-psychotic meds. Tens of thousands of HIV-positive people struggle to find the anti-retrovirals they need, forcing them into the kind of stop-and-go treatment patterns that doctors warn risk bringing on AIDS. Cancer patients can’t find chemotherapy drugs. Even malaria—which had essentially disappeared from Venezuela a generation ago and is easily treatable with inexpensive medicines—is making a deadly comeback.

Neighborhoods and shantytowns can go for days and even weeks with no piped water. Most people adapt by filling several buckets when service is provided, in preparation for the dry periods. Of course, storing water in buckets is precisely what you shouldn’t do when facing a mosquito-borne epidemic: The containers double as breeding grounds for the bugs that transmit the Zika virus, as well as others like Chikungunya, dengue, even malaria.

The same drought that’s forcing water rationing has seen water levels at the country’s electricity-generating dams fall alarmingly. Blackouts used to at least spare the capital, but these days they’re nationwide, as the public utilities struggle to keep enough water in the reservoirs to prevent a complete collapse in the power grid.