BOGOTA, Colombia – Television. Sewing machine. Motorcycle.
These are the things Edda Marchan’s children sold to keep their mother breathing.
In the far stretch of northern Peru where the family lives, medicinal oxygen to treat the coronavirus has become a scarce commodity.
Eventually, they could not find any.
“It’s the greatest desperation in the world,” said her daughter, 39-year-old Fiorella Sorroza. “We are praying to God not to abandon us.”
In the South American nation wracked by COVID-19, one of the world’s most abundant elements is now in short supply. Exasperated relatives are racing to fill overpriced tanks. Long neglected hospitals are running empty. And President Martin Vizcarra has issued an emergency decree ordering industrial plants to ramp up production or purchase oxygen from other countries.
“Peru, with the Amazon, has the lungs of the planet,” said Ivan Hidalgo, academic director of the Institute of Government and Public Management in Peru’s capital of Lima. “And we’re dying because of lack of oxygen.”
Regional health directors say the shortage has already cost lives and is so severe that even by turning industrial plants that typically produce oxygen for mining into medicinal production, Peru will fall short of what it needs. Defense Minister Walter Martos said Thursday the country needs 173 tons of oxygen per day. The dean of the Medical College of Peru estimates the nation is producing about 20% of that.
The problem is a consequence of decades of underinvestment in hospitals, corruption and poor management, several medical leaders said. The hospital in Tumbes, near the border with Ecuador, where Marchan’s family resides, has a plant that has been inoperative for years because someone stole an electronic card needed to operate it. Officials are hoping to get it back up Saturday.
In the meantime, Tumbes health workers have imported oxygen from Ecuador and trucked in tanks from the nearest Peruvian plant, five hours away. The biggest public hospital usually uses 30 tanks a week but now needs about 200.
Many also blame Peru’s governments for failing to prepare earlier.
“This exposes failings throughout the country,” said Dr. Harold Burgos, regional health director for Tumbes. “It was coming and no one took it seriously.”
Other countries in Latin America and the Caribbean are facing – or soon likely to encounter – oxygen shortages. In Colombia’s Amazon, doctors have had to airlift patients to Bogota because the only oxygen plant in the region is barely functioning. Haiti is heavily reliant on one oxygen plant for a population of over 11 million.
About 15% of all COVID-19 patients experience severe illness that requires oxygen therapy, while another 5% need ventilation, according to the World Health Organization. By the time many patients are critical enough to seek hospital attention, they often have low blood oxygen levels that require immediate attention.
That was the case for Armando Ancajima’s uncle, who was taken Sunday to a hospital in Talara, an oil producing city near Peru’s northern coast. Struggling to breathe, his nails purple, he had just 35% oxygen saturation on arrival. The family was told the hospital had no oxygen, suggesting that they rapidly find a way to buy it themselves.
Ancajima said he saw 10 people die during the night he spent with his uncle.
“This is the inheritance of 30 years of inattention,” he said.
Peru was one of the earliest nations in Latin America to institute a strict lockdown, but that failed to stop infections from skyrocketing. With nearly 185,000 cases, the country has the second-highest number in the region. Peru’s large informal sector – about 70% of the economy – means many have to break quarantines to earn money and buy food.
But the oxygen shortages are also symptomatic of the overall difficulties Latin America encountered in ramping up medical supplies during the pandemic. By the time the first cases were diagnosed in late February and early March, global supplies were drying up. Unable to buy from the U.S. or Europe, many turned to China for ventilators, which have been slow to arrive.
“The opportunity to buy goods had already passed when the first cases were diagnosed,” said Dr. Ciro Ugarte, director of the Pan American Health Organization’s health emergencies department.
Aid groups have tried to fill some of the gaps. The U.K.-based Hope Health Action will soon open a COVID-19 ward with 10 oxygen concentrators in the port city of Cap-Haitien in Haiti. The concentrators produce medicinal oxygen using electricity and ambient air.
Nonetheless, they have limitations. The machines typically supply up to 10 liters per minute, and severe COVID-19 cases can require more, said Rob Dalton, an emergency nurse with the organization. Each concentrator can serve just one patient.
“We need even more,” Dalton said. “We need as many as we can get.”
In Peru, Vizcarra on Thursday announced nearly $25 million to purchase oxygen and $3.2 million to develop plants and generators.
“If we can meet the demand nationally, we will,” he said. “If plants and generators cannot be secured that way, we’ll go wherever necessary.”
Perhaps the most severe shortages have been in Peru’s Amazon, where doctors in Iquitos were tending to 500 patients in a hospital meant for 225. With no oxygen plant, health workers were depending on outside shipments until recently. The government promised 60 tanks a day by air, though only 24 were arriving.
With the help of the church and local communities, two plants have since been purchased and overall need and shortages have gone down.
But the oxygen scarcity is increasingly being felt outside the Amazon as well.
In recent days, lines of people waiting to fill oxygen tanks for loved ones with COVID-19 have been seen even in better-equipped Lima. And in northern Peru, where Marchan’s family lives, many say price gougers are taking advantage.
The family was spending about $150 a day on oxygen until recently, hoping to avoid taking her to the hospital, which doctors warned was on the verge of collapse. But as she grew worse and no oxygen could be found, they decided to seek help.
A day after admitting her to the hospital, Sorroza said a doctor called, saying they didn’t have oxygen and asking the family to bring some. Later that night, she said, one doctor called a cousin offering to sell them a tank for around $120.
Three days later, she was dead.
The family was alerted at 6 a.m. on a Saturday that she’d died and was told she’d be buried four hours later at a newly created cemetery. They rushed to say a hasty goodbye, enlisting a carpenter cousin to construct a simple white cross out of wood.
“I didn’t get to see her,” Sorroza said. “Nothing.”
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