CARACAS – A breast cancer diagnosis is terrifying enough at any time. But for 49-year-old Grecia Solis, the arduous choices faced by all cancer patients were complicated by the crippling decline of Venezuela’s public health facilities.

After her diagnosis two years ago, doctors recommended surgery, chemotherapy and radiotherapy. Before the oil-producing nation’s steep economic decline of recent years, those services would have been available free of charge or for a nominal fee at a state-run public hospital.

But trained staff, medicines and equipment are in such short supply at those facilities today that a public hospital was no longer an option. Instead, Solis was forced to borrow money from family and friends to pay for her operation at a privately run, for-profit clinic.

Her operation, performed in May 2018, cost her $500, a modest amount by U.S. standards, but a huge sum in Venezuela where hyperinflation has ravaged most people’s savings. With additional financial help from a sister in Ecuador, Solis was able to pay for the recommended eight sessions of chemotherapy, which were completed in December.

Solis’ story is a common one among cancer patients in Venezuela. Patients are not just afraid of the disease itself, but they also fear dying because they cannot find or afford the necessary treatment.

Last year, about 4,700 women in Venezuela became ill with breast cancer, according to the Anticancer Society of Venezuela, although the nation’s health ministry has not produced official figures since 2012. The society reported 2,300 women died last year from the disease, one of the leading causes of cancer deaths among Venezuelan women.

Senos Ayuda, an NGO that supports breast cancer patients, estimates the number of patients are even higher, at almost 7,000 a year. And it stresses that treatment, medicine and doctors are becoming ever less accessible with the deepening of the nation’s humanitarian emergency.

The problem is part of a wider crisis in public health facilities. According to several Venezuelan doctors’ organizations, 73% of the country’s operating rooms are out of service or lack supplies and have unsanitary conditions.

A survey conducted by the organization Doctors for Health indicated that 90% of radiotherapy facilities are inoperative, 94% of health centers cannot take an X-ray, and 88% of hospitals have insufficient supplies and medicines. The Anticancer Society of Venezuela has reported that 80% of public radiotherapy equipment has been inoperative in the last year.

Solis says she is frustrated the government of President Nicolas Maduro does not accept that Venezuela is in a humanitarian crisis and has done little to address the problem, leading to avoidable cancer deaths.

Another patient, 58-year-old Algeria Dias, was diagnosed with a breast tumor in August 2017. She was able to afford treatment with the help of family, donations, some government help and the sale of the family car, but she says she now she spends every day “going from clinic to clinic, public and private, and see if they have the space or equipment I need to monitor my disease.”

For her part, Solis says she is running out time. She has until December to raise $5,000 to pay for more than 30 additional radiotherapy sessions to prevent the likely return of her cancer.

“Cancer does not wait. Cancer does not warn and when you have it, it overtakes you. It hurts having the uncertainty of not knowing if you can say, “I am a cancer survivor,” she said.