Venezuela's public health system is in dire straits. Malaria, eradicated from much of the country by the 1960s, is surging. Nearly 45,000 cases have been reported so far in 2014, compared with 32,000 in all of 2008. Dengue is spiking, and the country is bracing for a wave of the newly arrived chikungunya, a debilitating virus that's spread by the same mosquito that transmits dengue. In the meantime, maternal mortality rates have increased from 59 deaths per 100,000 births in 1990 to nearly 71 in 2011. Venezuela's porous borders with Guyana and Brazil, which are frequently crossed by illegal miners, increase the risk of infectious diseases spreading in the region. And Venezuela is hard up for dollars, which makes it nearly impossible to import medical supplies. The lack of medicines is confounding efforts to control chronic diseases like diabetes and hypertension.