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Caracas, Venezuela —

Venezuela was broken long before two back-to-back earthquakes ripped the country from its foundations last Wednesday. The effects of more than a decade of government mismanagement and economic sanctions are clear at Dr. José Manuel de Los Ríos Children’s Hospital in Caracas, where Dr. Huníades Urbina-Medina can treat only four children at a time in the intensive care unit.

“We (once) could receive up to 10 patients” in the ICU, Urbina-Medina said. “But since at least 10 years ago, we don’t have enough personnel, we don’t have enough medicines, we don’t have enough mechanical ventilators.”

One of the four patients receiving treatment is a 12-year-old girl who was crushed under several floors of a collapsed building. She is in agony, with numerous life-threatening injuries.