At a soup kitchen in the western Venezuelan city of Maracaibo, hungry and bedraggled men, women and children line up for free lunch. But it's meager fare: They each get a bottle of milk and a few scoops of rice mixed with eggs and vegetables.

Just a few years ago, the lunch program, which is run by the Catholic Church, provided full meals with meat and chicken, as well as fruit juice and even dessert. But amid a deep economic depression and an outbreak of looting in the city, dozens of Maracaibo businesses that used to donate food have closed down.

"We still feed 300 people per day, but it's a reduced menu," says Sara Cooper, a volunteer server. "We have to work with what we have."

Local charities are playing a growing role amid Venezuela's unprecedented humanitarian crisis marked by widespread malnutrition and deaths from preventable diseases. With President Nicolás Maduro's government reeling and in the absence of a massive influx of international assistance, small aid groups are struggling to feed the hungry and treat the sick.

Maduro has refused to declare a humanitarian emergency in part, analysts say, because that would be a tacit admission that his government has failed. But aid workers say that Maduro's stance makes it impossible for international agencies, like the Red Cross, UNICEF and the World Food Programme, to airlift and distribute the tons of supplies that Venezuela needs.

"If the government does not recognize the situation, that limits our ability because the entrance of aid into the country has to be approved by the government," says Carlos Montiel, president of the Venezuelan Red Cross in the western state of Zulia, which includes Maracaibo. "Lives are at risk because we do not have enough supplies."

Maduro insists that Venezuela is getting help from allies like China, Russia, India and Turkey. In a recent speech, he said these nations are sending "hundreds of tons" of supplies to Venezuela.

But aid workers in Maracaibo claim they haven't seen any of it. What's more, food and medicine sent from overseas often get stolen upon arrival at airports in the country or by soldiers at military checkpoints who sometimes demand a cut of the supplies, says Feliciano Reyna, founder of Action for Solidarity, which distributes medicine throughout Venezuela.

In addition, aid groups are facing more scrutiny from the Maduro government. That is partly because the U.S.-backed political opposition in February tried to force tons of humanitarian aid into the country from Colombia as part of an effort to foment regime change. One consequence, aid workers say, is that their efforts are often misconstrued by officials as anti-government activism.

Franklin Montilla, a cook at the Maracaibo soup kitchen, says local bureaucrats recently accused it of serving food in unsanitary conditions and participating in anti-government activities.

"They began to spread false information that there were outbreaks of diarrhea and that we were forming an opposition political movement," Montilla says. "They wanted to close us down."

Gustavo Rincón, president of the Maracaibo-based medical charity Samaritan Foundation, said Venezuela's secret police began monitoring his organization after he volunteered to help opposition leaders distribute aid in poor neighborhoods.

"They are trying to intimidate me because if we bring in aid that's bad for the government's image," he says.

Rincón's day-to-day struggles are typical of those faced by grassroots Venezuelan charities. When NPR recently visited his office, a blackout had left it in the dark and he was unable to get on his computer to check inventory or send out requests for donations.

Inflation last month was over 815,000%, the opposition-led legislature reported this week. Rincón says his rent is so high he fears he may soon have to move, if not close down.

Owing to a lack of spare parts, none of the foundation's five vehicles are working, Rincón says. Even if they were, gasoline shortages often prevent him from delivering supplies.

Rincón hadn't been to a nearby leper colony for the past five months. He is anxious to see how the patients are doing, but the only way to get there is in a taxi hired by NPR. Along the way, Rincón stops at a grocery to load up on eggs, plantains, cheese and chicken for the patients.

Rincón receives a hero's welcome from the patients, some of whom are missing fingers, ears and, in one case, both legs. Food donations are so rare that they often share them with malnourished medical personnel.

The state-run leprosy hospital is so neglected that nurses say they sometimes stop traffic in front of the building to beg for food. Thieves recently stole electric cables, leaving half of the facility without air conditioning in the 100-degree heat. Some of the beds have been moved outdoors to take advantage of a slight breeze.

"They are completely abandoned," Rincón says, shaking his head.

That's why, despite his own difficulties, Rincón promises that he'll be back. As he leaves one of the patients says: "May God bless you."

Copyright 2019 NPR. To see more, visit https://www.npr.org.

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