CARACAS (Reuters) - Yasmira Castano felt she had a fresh chance at life when she received a kidney transplant almost two decades ago. The young Venezuelan was able to finish high school and went on to work as a manicurist. 
 
 But late last year, Castano, now 40, was unable to find the drugs needed to keep her body from rejecting the organ, as Venezuela’s healthcare system slid deeper into crisis following years of economic turmoil. 
 
 On Christmas Eve, weak and frail, Castano was rushed to a crumbling state hospital in Venezuela’s teeming capital, Caracas. Her immune system had attacked the foreign organ and she lost her kidney shortly afterwards. 
 
 Now, Castano needs dialysis three times a week to filter her blood. But the hospital attached to Venezuela’s Central University, once one of South America’s top institutions, frequently suffers water outages and lacks materials for dialysis. 
 
 “I spend nights not sleeping, just worrying,” said Castano, who weighs around 77 pounds (35 kg), as she lay on an old bed in a bleak hospital room, its bare walls unadorned by a television or pictures. 
 
 Her roommate Lismar Castellanos, who just turned 21, put it more bluntly. 
 
 “Unfortunately, I could die,” said Castellanos, who lost her transplanted kidney last year and is struggling to get the dialysis she needs to keep her body functioning. 
 
 The women are among Venezuela’s roughly 3,500 transplant recipients. After years leading normal lives, they now live in fear as Venezuela’s economic collapse under President Nicolas Maduro has left the once-prosperous OPEC nation unable to purchase sufficient foreign medicine or produce enough of its own. 
 
 Some 31 Venezuelans have seen their bodies start to reject their transplanted organs in the last month due to lack of medicine, according to umbrella health group Codevida, a non-governmental organization. 
 
 At least seven have died due to complications stemming from organ failure in the last three months. 
 
 A further 16,000 Venezuelans, many hoping for an elusive transplant, are dependent on dialysis to clean their blood - but here too, resources and materials are sorely lacking. 
 
 Nearly half of the country’s dialysis units are out of service, according to opposition lawmaker and oncologist Jose Manuel Olivares, a leading voice on the health crisis who has toured dialysis centers to assess the scale of the problem. 
 
 In the last three weeks alone, seven people have died due to lack of dialysis, according to Codevida, which staged a protest to decry the critical drug shortages. 
 
 Once-controlled diseases like diphtheria and measles have returned, due partly to insufficient vaccines and antibiotics, while Venezuelans suffering chronic illnesses like cancer or diabetes often have to forgo treatment. 
 
 Hundreds of thousands of desperate Venezuelans, meanwhile, have fled the country over the past year, including many medical professionals. 
 
 Amid a lack of basics like catheters and crumbling hospital infrastructure, doctors who remain struggle to cope with ever scarcer resources. 
 
 Yasmira Castano, 40, who lost her transplanted kidney, lies on a bed at a state hospital in Caracas, Venezuela February 7, 2018. Castano was unable to find the drugs needed to keep her body from rejecting the organ. On Christmas Eve 2017, she was rushed to a state hospital. Her immune system had attacked the foreign organ and she lost her kidney shortly afterwards. REUTERS/Carlos Garcia Rawlins 
 
 “It’s incredibly stressful. We request supplies; they don’t arrive. We call again and they still don’t arrive. Then we realize it’s because there aren’t any,” said a kidney specialist at a public hospital, asking to remain anonymous because health workers are not allowed to speak publicly about the situation. 
 
 Venezuela’s Social Security Institute, tasked with providing patients with drugs for chronic conditions, did not respond to a request for comment. 
 
 “STRAIGHT TO THE CEMETERY” 
 
 Terrified transplant patients are indebting themselves to buy pricey medicine on the black market, begging relatives abroad to funnel drugs into the country or dangerously reducing their daily intake of pills to stretch out stock. 
 
 Larry Zambrano, a 45-year old father of two with a kidney transplant, resorted to taking immunosuppressants designed for animals last year. 
 
 Guillermo Habanero and his brother Emerson both underwent kidney transplants after suffering polycystic kidney disease. Emerson, a healthy 53-year-old former police officer, died in November after a month without immunosuppressants. 
 
 “If you lose your kidney, you go to dialysis but there are no materials. So you go straight to the cemetery,” said Habanero, 56, who runs a small computer repair shop in the poor hillside neighborhood of Catia. 
 
 A Reuters reporter went to the Health Ministry to request an interview, but was asked at the entrance to give her contact details instead. No one called or emailed. 
 
 Reuters was also unable to contact the Health Ministry unit in charge of transplants, Fundavene, for comment. Its website was unavailable. Multiple calls to different phone numbers went unanswered. An email bounced back and no one answered a message on the unit’s Facebook page. 
 
 Maduro’s government has said the real culprit is an alleged U.S.-led business elite seeking to sabotage its socialist agenda by hoarding medicine and imposing sanctions. 
 
 “I see the cynicism of the right-wing, worried about people who cannot get dialysis treatment, but it’s their fault: they’ve asked for sanctions and a blockade against Venezuela,” Socialist Party heavyweight Diosdado Cabello said in recent comments on his weekly television program. 
 
 Health activists blame what they see as Maduro’s inefficient and corrupt government for the medical crisis and contend that government announcements of more imports for dialysis are totally insufficient. 
 
 Despite his unpopularity, Maduro is expected to win a new six-year term in an April 22 presidential election. The opposition is likely to boycott the vote, which it has already denounced as rigged in favor of the government. 
 
 Maduro has refused to accept food and medicine donations, despite the deepening healthcare crisis. Health activists and doctors smuggle in medicines, often donated by the growing Venezuelan diaspora, in their suitcases, but it is far from enough. 
 
 In the decaying hospital and dialysis center visited by Reuters, patients clamored for humanitarian aid. 
 
 Dolled up for her birthday and surrounded by cakes, the 21-year-old Castellanos took selfies with her friends and spoke excitedly about one day returning to dance, one of her passions. 
 
 Slideshow (13 Images) 
 
 But fears for her future permeated the room. A hospital worker stopped by to wish Castellanos many more birthday celebrations but her worried face betrayed doubts. 
 
 “Other countries need to help us,” Castellanos said. ||||| They were driving near the Maine Mall when they saw the message written in bright yellow paint on the rear window of another car: “Looking for someone to donate me their kidney. Must have type O blood.” There was a phone number. 
 
 “I looked over,” says Ashley Dall-Leighton, “and I go, ‘Oh, my God, that’s the saddest thing I’ve ever read.’ And he’s like, ‘What?’ And I read it out loud, and he said, ‘Did you get the number? Text her right now.'” 
 
 And that’s how Josh Dall-Leighton, a 30-year-old corrections officer from Windham with three children, came to offer one of his kidneys to a woman he’d never met. 
 
 ••• 
 
 Christine Royles of South Portland was diagnosed with lupus in December of 2013. A few months later, doctors discovered she had a second autoimmune disease, ANCA vasculitis. 
 
 They also told her that her kidneys were failing. 
 
 Only 23, she joined a waiting list of more than 100,000 people in the United States who need kidney transplants, according to the National Kidney Foundation. 
 
 Fewer than 17,000 receive one each year, with about a third of the kidneys coming from living donors. In 2013, 4,453 patients died while waiting for kidney transplants. 
 
 Christine didn’t like those odds. She decided to take matters into her own hands. 
 
 “I saw a story about this old man in a different state who was asking for a kidney for his wife,” says Christine, now 24. “He stood on the side of the road with a sign.” 
 
 Instead of standing on the side of the road, she decided to turn her car into a rolling billboard. 
 
 “My fiancé thought it was kind of weird,” she says. 
 
 But it worked. 
 
 ••• 
 
 Kidneys are bean-shaped organs, each about the size of a fist, that sit in the rear of the abdominal cavity. Their job is to filter waste from the bloodstream. Humans are born with two, but it’s possible to lead a healthy life with one. 
 
 “You can live with one kidney,” says Jen Dalton, the clinical coordinator at Maine Nephrology Associates, “because that one kidney essentially takes over the job of two.” 
 
 People who need transplants are put on the national waiting list, but they can bypass it by finding a living donor themselves. Most living donors are family members, friends and acquaintances. But more and more, people are expanding the search. 
 
 “We see people using social medial or putting ads out for altruistic donors,” says Sean Roach, the public relations manager for the National Kidney Foundation. “It takes a lot of courage to put yourself out there like that.” 
 
 Finding a willing candidate is only the first step. A recent study presented to the American Society of Nephrology found that fewer than half of Americans meet the criteria to donate; those who aren’t eligible have health conditions such as obesity, hypertension and diabetes. Many others simply can’t afford to take the time off from work; the average donor stays in the hospital for at least two days and takes three to six weeks to recuperate. 
 
 A person who donates a kidney is generally able to lead a full, healthy life afterward but should be tested regularly for signs of potential kidney damage. They are advised to keep their weight and blood pressure down, but don’t require special diets or medication. 
 
 “In absolute numbers,” says Dr. John Vella, director of the Maine Transplant Program, “the chance of a kidney donor needing dialysis at some point is very much less than 1 percent.” 
 
 ••• 
 
 Josh, who works as a corrections officer at the Southern Maine Re-Entry Center in Alfred, says he didn’t think twice after seeing the sign on Christine’s car. 
 
 “I just looked at my wife and said, ‘I have to try,'” he says. “I think it was the fact that I have three kids of my own, and that really resonated with me. If (my wife) needed a kidney and I couldn’t provide for her, I would hope that somebody else would kind of step up and help her out.” The Dall-Leightons’ twins, Mason and Christopher, are 10 months old. Their brother, Hayden, is 5. 
 
 Christine put Josh in touch with Maine Medical Center’s Transplant Program. After undergoing extensive tests this winter, Josh learned last month that he is a strong potential match. 
 
 He and Ashley texted Christine with the news. 
 
 “I started crying,” Christine says, “because, oh, my God, I can’t believe he’s gonna do this for me.” 
 
 Ashley was wary at first about the prospect of her husband donating a kidney, but quickly put her concerns aside. 
 
 “(Josh) just told me all along that this is what he needs to do, and if this is what he needs to do, then I support him 100 percent,” she says. 
 
 ••• 
 
 Christine and the Dall-Leightons, who had been getting to know each other through texting and Facebook, finally met for the first time Tuesday. 
 
 Christine drove to Windham and knocked on the couple’s door, holding the hand of her 2-year-old son, Talan. Josh, holding 10-month-old Christopher in his arms, opened the door and gave her a hug. 
 
 She told him it’s hard to find the words to say thank you. But Josh said it isn’t necessary. 
 
 “I just want you to get better,” he says. “I just want to hear that donating helped you.” 
 
 For now, Christine continues to live a life consumed by her disease: weekly doctors’ appointments, trips to the hospital, mountains of medication. Every night, after she gets home from her job waitressing at Applebee’s and reads a bedtime story to Talan, she tethers herself for 10 hours to the portable dialysis machine that keeps her alive. 
 
 Because Christine has permanent kidney failure, Medicare is covering the cost of the transplant, which averaged roughly $262,000 in 2011, according to a U.S. Department of Health and Human Services website. Final testing on Josh should be completed in the next few weeks, and the transplant surgery is tentatively scheduled for mid-May. He expects to be out of work, on unpaid leave, for about a month. 
 
 Christine is now trying to raise money to help the family that’s helping to save her life. 
 
 “I’m shocked that someone is going to do this for me,” Christine says. “The fact that someone with a young family is going to take time off work to help some random person is unbelievable to me.” 
 
 But Josh says his gift to her isn’t a debt to be repaid. It’s simply the right thing to do. 
 
 As he talks, his twin sons squirm in his lap. 
 
 “I want these boys to know that if somebody needs help, you do whatever you can to help them,” he says. “I want them to know these aren’t just words I’m telling them. That I actually did something to help somebody.” 
 
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– There's a literal casualty of Venezuela's ongoing economic woes: those with kidney problems. Reuters dives into the dire situation that both kidney transplant recipients and those hoping to join their ranks face in the midst of the country's inability to buy enough drugs from abroad or make enough domestically. USA Today cites the Pharmaceutical Federation of Venezuela in saying the country was experiencing an 85% shortage of medicine—and that was as of June 2017. There are some 16,000 people who require dialysis, but the country's ability to clean their blood is waning, with an opposition lawmaker and oncologist saying only about half of the country's dialysis units are operational. Codevida, a health-related NGO, logged seven deaths in the first few weeks of February due to a lack of dialysis. But dialysis patients, many hopeful for a future transplant, aren't the only ones dying. About 3,500 Venezuelans have had kidney transplants, and that number is slowly being chipped away at as they find themselves unable to obtain the anti-organ rejection drugs they need to take for the rest of their lives. A 40-year-old woman lost the transplanted kidney she's had for nearly 20 years and is now on dialysis, though she's encountering issues there, too; a 45-year-old man is trying to hang onto his by taking immunosuppressants made for animals. In the case of two brothers who received transplants, one died in November after going a month without medicine. Says his brother, "If you lose your kidney, you go to dialysis, but there are no materials. So you go straight to the cemetery." Deutsche Welle reports HIV patients there are trapped in a similar situation.