CARACAS, Venezuela (AP) — Doctors said Wednesday they feared the aftermath of Venezuela’s devastating twin earthquakes could trigger a widening medical crisis marked by untreated injuries, infectious diseases and a healthcare system already on the brink.

Thousands of displaced Venezuelans are sleeping in crowded shelters or outside without access to clean water amid dismal sanitary conditions following the June 24 earthquakes which officials say killed at least 2,295 and left more than 11,000 injured.

Aid workers said the aftermath of the quakes has become a major medical crisis that, unless quickly controlled, would take more lives in the days and weeks ahead. The emergency has laid bare Venezuela's chronic shortage of doctors, the result of years of economic crisis, underfunding and emigration.

“The issue we foresee just around the corner is the infections that patients who have been exposed to the disaster for the longest time might bring,” said Eugenio Cova, the head of the trauma unit at Hospital del Oeste Dr. José Gregorio Hernández in Caracas, the capital. “We’ve already gone through a period of complex trauma — which will continue to occur — but now it’s complicated by infections."

Aid workers also warn that the extensive damage to infrastructure could fuel outbreaks of diseases in the hardest-hit communities.

“It’s very hot and there’s a lot of concern about potential vector-borne diseases,” said Veronique Durroux, the U.N. humanitarian agency spokesperson for Latin America and the Caribbean. “Waste management is an issue. Debris management, when you see the scale of devastation, it’s very concerning.”

The United States had 900 military personnel currently on the ground to support relief and rescue operations as of Wednesday, Steven McLoud, a U.S. Southern Command spokesperson, told The Associated Press.

The military has repaired an earthquake-damaged runway at the country's main international airport that serves Caracas to allow for the arrival of humanitarian assistance and stationed naval assets off the coast to receive airlifted survivors. An additional 100 people from the U.S. State Department have been sent to aid those efforts, McLoud said.

So far, the Trump administration has offered Venezuela $300 million in assistance channeled through aid groups and the United Nations. But that's just a fraction of the post-earthquake aid the country needs: Material damage from the quakes is estimated at over $6.7 billion, according to satellite analysis by the U.N. Development Program.

Fifty other international teams have arrived in recent days to help with search-and-rescue operations, including from countries like Ecuador and Israel that don't have diplomatic relations with Venezuela. Against the odds, rescuers are continuing to find a small number of survivors, including on Tuesday, a toddler who had been trapped for six days.

Long before the earthquakes, Venezuela's public hospitals were strained by shortages of water, energy, critical medical equipment and highly trained staff.

More than 7.7 million Venezuelans have left the country since 2013, when Nicolás Maduro took office and the economy came undone as a result of mismanagement, corruption and a drop in oil prices.

Among those who took flight were many specialized doctors and nurses.

Venezuela’s medical association has estimated that about a third of its 60,000 registered physicians have left the country since the economic crisis began. Dr. Huníades Urbina, a member of the board of the pediatrics association of Venezuela, said the number left is roughly half of the 84,000 that the country needs based on World Health Organization standards.

Urbina added that a 2025 national survey of public hospitals revealed shortages of more than 30% of emergency supplies and more than 70% of supplies in operating rooms. Laboratories are “all practically closed or do the basic things only," he said.

The earthquakes "once again highlight the Venezuelan government’s inability to provide an adequate health care system that meets the needs of the Venezuelan people,” he said.

Those who remain now confront the overwhelming prospect of treating thousands of grievous injuries from crushed and caved-in concrete structures.

Hospital del Oeste Dr. José Gregorio Hernández in Caracas lacks screws and plates needed for orthopedic surgery and medicated gauze to prevent infections, said Cova, who conducts surgery on crushed limbs in makeshift operating rooms because possible earthquake damage has made parts of the building inaccessible. Doctors have even started posting what medical supplies they need on social media, asking for donations.

According to the government, the earthquakes damaged or otherwise compromised 38 hospitals nationwide.

There's also a nationwide shortage of ambulances that forces many injured Venezuelans to arrive at hospitals in the backs of pickup trucks, said Jaime Lorenzo, director of United Doctors of Venezuela, a nonprofit network of medical professionals. That's just one of the ways that ordinary citizens, feeling abandoned by the government, say they've been forced to shoulder much of the rescue effort.

When the chaos and trauma of the quakes starts to subside, Lorenzo said he fears a new wave of patients will hit hospitals: Venezuelans, who, rendered suddenly homeless after the earthquakes, have gone all week without medication for chronic diseases such as asthma, diabetes and high blood pressure.

The government of acting President Delcy Rodríguez — who served as deputy to Maduro until he was ousted by the United States in January and who became interim leader with the backing of the Trump administration — has faced growing criticism over its handling of the disaster.

Videos circulating on social media in recent days appear to show security officers picking through the rubble of fallen buildings and making off with U.S. dollars, appliances and other personal belongings and sparking widespread anger among Venezuelans. The videos couldn't be verified by the AP.

In response to the videos, the Interior Ministry on Wednesday said it dismissed and detained four police officials for “deviating from their duties and taking advantage of the rescue and humanitarian aid efforts."

Many thousands remain missing, adding ambiguity to the complete toll and leaving families in an agonizing limbo as they wait days by collapsed buildings, hoping for the bodies of their loved ones to surface. One non-governmental digital database where families can register missing loved ones showed over 40,600 people still unaccounted for as of Wednesday.

On Wednesday, U.S. officials pushed back against accusations that Rodríguez was politicizing response efforts and brushed off widespread criticisms of failures by Venezuela's government to respond to the crisis. Gen. Francis Donovan, head of U.S. Southern Command, turned blame on decades of neglect in Venezuela which he said “made this even more challenging for the current government.”

“It is a big problem for any leader to deal with a challenge of this magnitude,” Donovan said.