How Venezuela’s earthquake amputees adapt to life without limbs
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Ricardo Contreras’s new leg rests on a wooden countertop.
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More than four months after twin earthquakes struck Venezuela, the 24-year-old is still recovering from his injuries.
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When he was trapped beneath the rubble on the night of June 24, he waited hours to be rescued. His left leg had been pinned beneath a fallen door frame, limiting its blood circulation. It had to be amputated.
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“One of the biggest achievements is that we survived,” Ricardo said, glancing towards his 16-year-old brother, Andres Contreras. “At first, when I found out Andres was well, I didn’t care about my leg too much. I would have chosen a thousand times over for Andres to be OK.” But now Ricardo is adapting to his new reality.
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He and his brother are still undergoing physiotherapy for their injuries.
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On a scorching afternoon, he sits in a small workshop in the hills of northwestern Caracas, waiting to do rehabilitation exercises to prepare for his new prosthetic leg. “Now it’s about regaining a little of the independence I had before the earthquake, because that’s what limits me most," Ricardo said.
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But recovery is only part of the challenge he is facing.
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His parents died in the collapse. Resources and aid have also grown scarcer, particularly as global attention faded and international donations dried up.
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As of September, the United Nations Children's Fund (UNICEF) said it had secured only $29.5m of the $65.7m needed to continue its earthquake support in Venezuela, a shortfall of 55 percent.
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Separately, that same month, the International Red Cross said its Venezuela response effort was only 39.8 percent funded.
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Not only are survivors like Contreras left to grapple with loss of limbs and family members, but they now face the prospect of lifelong health costs — with dwindling support.
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More than 6,500 people have been confirmed dead as a result of the earthquakes, according to government authorities.
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At least 226,696 people have received hospital treatment for injuries.
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The government says it has compiled a census of amputees, but no details have been made public. At Ortoprotecnica, a Caracas workshop that makes prosthetic limbs, director Bianca Damaso is helping survivors like Ricardo through the next stages of recovery.
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For those who have lost limbs, it typically takes two to three months of physiotherapy, rehabilitation and preparation to be ready for a prosthesis — sometimes longer depending on how their wounds heal and any pre-existing health conditions.
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“It’s a very individual process where you have to support each person from where they are, because some are very anxious to have the prosthesis already, but their skin hasn’t even healed yet,” Damaso explained.
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She said there are more than 100 types of knees to choose from, as well as more than 200 skin shades.
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But the process does not end with the first fitting.
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Children may need five or six replacement prostheses as they grow, while adults might require ongoing adjustments and repairs. Then there are the psychological hurdles.
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Many earthquake survivors wonder about practical realities like whether they will walk again, whether they will need a wheelchair or whether they will be able to urinate independently. Many, in Damaso's experience, also question whether they will find a partner who will love them.
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"Right now, the challenges for them are going to be more than just physical.
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They’re mental battles," Damaso said. There is one rule she is adamant about in her workshop: “We tell them that the only thing that’s forbidden here is saying, ‘I can’t.’” Karina Bechara, who lost both her legs in the earthquakes, is hoping to stand on her new feet by December 1.
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For now, she relies on a wheelchair.
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“That motivates me every morning to get up and say, 'One day less to go.' It's painful, yes, but we're getting closer to the goal,” Bechara told Al Jazeera. Before the earthquake, Bechara ran her own business and had an active life, training regularly with high-intensity CrossFit workouts.
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Her children saw her as an independent mother who did not depend on anyone.
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“Now I am the opposite, a mum who needs their help, a dependent mum,” Bechara said. After the earthquakes struck, Bechara was stuck in the rubble for 23 hours, immobilised by a piece of heavy furniture that crushed her legs.
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She describes her recovery as an “emotional rollercoaster”.
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She said she allows herself to cry on the harder days but tries to keep looking ahead.
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“Because if I don’t see the future for myself, no one else will.” But readjusting to routines can be difficult for those who have sustained life-altering injuries — not to mention other losses. So far, Ricardo is optimistic about his daily activities.
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He has resumed work at his family's truck parts business, as well as his university studies.
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A new semester of classes has started, and he uses crutches to get around.
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“I was really quite nervous. I was even worried about where the classes will be because we have three floors and also the distances are long,” Ricardo said. But his concerns quickly melted away.
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The professors even moved his lessons to ground-floor classrooms to make the courses more accessible. “It was actually great going back," Ricardo explained.
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"My classmates have always been there, helping me.” The most difficult adjustment, however, has been grappling with the loss of loved ones. “If my leg hurts, I take a pill, but with that, there’s nothing I can do.
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There’s no cure, there’s no remedy, there’s nothing,” Ricardo told Al Jazeera. His mum and dad both died from suffocation during the earthquakes while the family was waiting to be rescued.
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Their building was one of dozens in the state of La Guaira to collapse.
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“I fell in the bathroom hugging my mother, and Andres fell near my father. She was telling me she was fine, but I saw that her head was covered with concrete, with a wall on top, and dust,” Ricardo said.
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Before the earthquakes, he remembers his mother cooking, singing and spoiling the family dog, who also died in the destruction. He credits his father with teaching him and Andres the value of work and the importance of being strong.
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The brothers often look through photographs of their parents on their phones. One shows their family home, overlooking the sea.
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Another has them by the pool. “As time goes on, the crying is the same, but the reason is different.
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Instead of crying so much from sadness, it's more like remembering the good times,” Ricardo said. Following his parents' death, Ricardo has taken on additional responsibilities beyond school and work. He is now Andres's legal guardian, and he is hoping the pair can soon find a home of their own through a government housing programme for earthquake victims.
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His university has also offered him a full scholarship to finish his studies, to help relieve the financial burden. Money, however, is still expected to be tight.
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The average salary for a private-sector worker in Venezuela is not much more than $200 a month.
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“Of course, I'm worried about my financial situation,” Ricardo said, explaining the family business has slowed since the earthquakes.
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“Sometimes it's hard to cover all the expenses, given everything that's happened, but we find a way.
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I think that's what Venezuelans do: We’re always finding a way to make things work.” The Juan Pablo Dos Santos Foundation, a Venezuelan nonprofit, is among the groups helping earthquake amputees. Its founder and namesake, Dos Santos, lost his legs in a car accident in 2019.
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He remembers realising the scale of June's tragedy when, at the first hospital he visited, he encountered a ward with 12 children.
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All of them had either lost limbs or were facing amputation. “It's very difficult for everyone in general but especially for children, who suddenly lost so much.
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They lost family members, their homes, their schools, their abilities, and on top of that, they're missing a part of their body,” he told Al Jazeera. One of his priorities was to show them what their lives could look like after amputation, telling them of his own achievements as an athlete and model.
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But alongside the physical and psychological challenges, he knew they would face another obstacle: the cost of prosthetics. “A prosthesis for a below-knee amputation, which is a transtibial prosthesis, can cost between $3,000 and $5,000," Dos Santos said.
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"And a prosthesis for an above-knee amputation can cost between $7,000 and $12,000." The price tag for artificial limbs with electronic components — that react to the body's muscles — can stretch even higher, into the tens of thousands of dollars.
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Even before the earthquake, the foundation had a waiting list of hundreds of people who needed a prosthetic limb but could not afford one.
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After the seismic disaster, some 200 people were added to its database, Dos Santos said.
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He explained that the foundation focuses on functional prostheses rather than the most expensive technology, partly because patients also need to be able to afford adjustments, repairs and replacements. For many families, the cost is simply beyond reach.
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The foundation is now planning to set up a specialist orthotics and prosthetics centre in Venezuela, which it says is essential to provide ongoing support for amputees.
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Medical professionals also see continued care as fundamental to recovery.
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“For patients who suffered serious injuries or amputations, being saved and discharged from hospital is only the beginning.
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The recovery can be long, and that’s where we encounter many limitations,” Ana Rosario, the president of the Caracas Nurses Association, told Al Jazeera.
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She said the earthquake compounded problems in Venezuela’s health system, which was weakened by years of economic crisis.
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There are often too few nurses for the number of patients.
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Hospitals sometimes relied on supplies donated by citizens and organisations to help meet their needs.
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“Although healthcare is technically free, patients may still have to pay for medicines, medical supplies, tests, transport and rehabilitation,” Rosario said. “And these are costs that can continue for months.” For families who cannot afford them, the consequences can be serious.
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“We see it every day: Families ask for help through social media, look for donations, go into debt, or simply have to wait,” she said.
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“When a test, medication or procedure is delayed, recovery can also be delayed, and new complications can arise.” For survivors like Ricardo, private donations through organisations such as the Juan Pablo Dos Santos Foundation are helping pay for prosthetic limbs and rehabilitation. “A few days ago, I saw my leg being made, and that got me really excited,” Ricardo said.
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Though Ricardo is his guardian, Andres explained they help care for one another as they each recover from their injuries. “Just getting out of the wheelchair was already a big step," Andres said of his brother.
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"He’s getting better every day.
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Honestly, it makes me so happy that he’ll be able to walk again." The brothers attend physiotherapy sessions together, with Andres encouraging his older brother as he learns to walk again.
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“My brother makes me feel like a world champion,” Ricardo said, laughing as his younger brother breaks into a smile.
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