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China Eases Rules on Cheap Drug Imports to Fight Chronic Diseases

Westlake Legal Group 27chinadrugs-1-facebookJumbo China Eases Rules on Cheap Drug Imports to Fight Chronic Diseases smuggling Politics and Government Medicine and Health Law and Legislation International Trade and World Market Drugs (Pharmaceuticals) China cancer

BEIJING — China said it would reduce the penalties for the sale and import of unapproved drugs, effectively giving poor and critically ill patients the green light to access cheaper generic pharmaceuticals from other countries.

The move, announced on Monday, could help fill a gaping hole in the country’s overburdened health care system. For years, Chinese patients and their relatives risked the threat of heavy criminal penalties in their hunt for affordable drugs in a country increasingly suffering from chronic diseases like cancer. In the most desperate of cases, relatives of these patients have resorted to making their own cancer drugs at home using raw pharmaceutical ingredients that they have found online.

The effectiveness of the new move could depend on the details. The Chinese government said the changes to the current law would take effect on Dec. 1 but did not specify how penalties would be reduced.

Chinese law currently holds that drugs not approved by the National Medical Products Administration are “fake,” and companies and individuals caught selling such drugs could be fined up to five times their value as well as criminally charged.

Selling these drugs may result in a jail sentence of up to three years, even if there are no serious consequences, according to the state-backed China Daily newspaper. Harsher penalties may apply in more serious cases, it said.

Chinese state media said the changes could allow more people to obtain generic drugs from countries such as India without waiting for the approval of official regulators. In China, such drugs are currently purchased through “daigous,” or black market purchasing agents.

“This new move is significant because it redefines ‘fake or counterfeit drugs’ by focusing on their safety and efficacy, not on whether they obtain government approval,” said Yanzhong Huang, a senior fellow for global health on the Council on Foreign Relations, in an email.

“Under the new definition, a cheaper generic drug made in India can be imported and sold in China,” Dr. Huang wrote. “Given that these drugs are usually much cheaper than the prohibitively priced Western patented drugs, a significantly larger percentage of Chinese people can now afford those lifesaving drugs.”

According to Dr. Huang, the Indian version of the anti-lung cancer drug Iressa cost $10 a day in 2016, compared to $100 a day for the patented drug in China. He said that generic drugs cost, on average, 97 percent less than patented drugs sold in China.

The lack of access to drugs has taken on more urgency as the Chinese government grapples with the mounting health problems of its 1.4 billion people. Heart disease, strokes, diabetes and chronic lung disease account for 80 percent of deaths in China, according to a World Bank report in 2011.

Cancer diagnoses in China are soaring, and survival rates are low. About 4.3 million cancer cases were diagnosed in 2015, or almost 12,000 cases a day. That is nearly double the rate five years before, according to official figures.

In China, the public has long expressed frustration with their lack of access to effective drugs to treat those kinds of diseases. A 2018 film, “Dying to Survive,” was based on the real-life story of a Chinese leukemia patient who smuggled generic drugs from India to save himself and others. A box office hit, it was almost universally lauded for shedding light on the difficulties of getting cancer drugs in China. The movie’s popularity prompted Premier Li Keqiang to call for speeding up price cuts for the medication.

Even the rich in China contend that red tape and stringent regulatory rules prevent them from getting access to new drugs that are approved in the United States, and many say they are forced to fly overseas for treatment.

Yuan Jie, a senior official with the Standing Committee of the National People’s Congress, a top group of Chinese lawmakers, said the decision to redefine the scope of counterfeit drugs was “a response to the concerns of the people,” according to an official transcript.

In a statement, the National Medical Products Administration said the government would reduce punishment for the distribution of such drugs. If no harm is caused or no treatment is delayed, the parties can be exempt from punishment. And if the circumstances are deemed to be “relatively minor,” the parties involved will face “lighter penalties” if they are importing a “small amount” of drugs.

Drug approvals, while accelerating, remain dauntingly backlogged in China. Until October 2017, pharmaceuticals approved in the United States and Europe had to go through an extensive vetting process in China.

Chen Xi, an assistant professor of health policy and economics at the Yale School of Public Health, said in an email that while China has more than tripled the number of people evaluating new drug applications, “it is still far from meeting the rising and diversifying demand.”

Experts said they remain concerned about the enforcement of the law and that the vague terms such as “light penalties” and the lack of a definition of “small amount of unapproved drugs” give the government a lot of leeway to interpret them strictly.

Dr. Chen said a more significant step would be to continue improving the efficiency of drug approvals in China and reducing drug prices to meet the demand.

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‘El Chapo’ Guzmán Sentenced to Life in Prison, Ending Notorious Criminal Career

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He was one of the most notorious outlaws of the last 100 years: a brutal Mexican cartel leader, a wily trafficker who smuggled more than $12 billion worth of drugs and plunged his country into a long-running tragedy of bloodshed and corruption.

But on Wednesday morning, the 30-year criminal career of Joaquín Guzmán Loera, known to the world as El Chapo, reached its final chapter as a federal judge in New York City sentenced him to life in prison.

The life term, mandated by law as a result of the severity of Mr. Guzmán’s crimes, was handed down in Federal District Court in Brooklyn, where the kingpin was convicted last winter of drug, murder and money laundering charges after a sprawling three-month trial.

As some of the federal agents who had chased him for years looked on from the gallery, Judge Brian M. Cogan issued the sentence and Mr. Guzmán, 62, was hauled away to prepare himself — pending an appeal — for spending the rest of his life behind bars.

Before he disappeared into a holding cell behind the courtroom, he blew a kiss to his wife, Emma Coronel Aispuro, who attended most of his trial and was implicated in a handful of his crimes.

Although Judge Cogan had no choice but to sentence Mr. Guzmán to life, he noted that the “overwhelming evil” of the drug lord’s crimes was readily apparent. Beyond the life sentence — plus an additional 30 years — he ordered him to pay a staggering $12.6 billion in forfeiture.

Looking disheveled and slightly out of sorts, Mr. Guzmán walked into the eighth-floor courtroom under guard shortly before 9:30 a.m. He wore a loosefitting gray suit, with his tie rakishly askew and a new-growth mustache darkening his upper lip.

Reading from a prepared statement, he said he had not received a fair trial and complained about his solitary confinement in Manhattan’s federal jail, calling it “psychological, emotional and mental torture 24 hours a day.”

“Since the government of the United States is going to send me to a prison where my name will never be heard again, I take advantage of this opportunity to say there was no justice here,” he said.

Though Judge Cogan did not specify where Mr. Guzmán would serve his sentence, he is likely to be sent to the country’s most forbidding federal prison, the United States Penitentiary Administrative Maximum Facility, or ADX, in Florence, Colo.

Where El Chapo Could End Up: A Prison ‘Not Designed for Humanity’

Feb. 15, 2019

Westlake Legal Group merlin_150665514_653eacd9-9cb2-402b-9cb7-84602b5318e4-threeByTwoSmallAt2X ‘El Chapo’ Guzmán Sentenced to Life in Prison, Ending Notorious Criminal Career smuggling Sinaloa Cartel Prisons and Prisoners Politics and Government Guzman Loera, Joaquin Drug Cartels Drug Abuse and Traffic Brooklyn (NYC)

Mr. Guzmán’s decades-long career atop the Sinaloa drug cartel, one of Mexico’s most powerful criminal mafias, came to a close only after years of joint investigation and pursuit by the American and Mexican authorities.

His ability to persistently evade capture — and then escape from prison after he was caught — underscored the deep corruption of the Mexican government by his cartel, which used bribery and intimidation to control not just the local, state and federal police, but some of the highest-ranking officials in the national government.

“It’s justice not only for the Mexican government, but for all of Guzmán’s victims in Mexico,” said Raymond P. Donovan, the agent in charge of the New York office of the Drug Enforcement Administration, who was instrumental in capturing the kingpin twice.

After the sentencing, one of Mr. Guzmán’s lawyers, Jeffrey Lichtman, spoke outside the courthouse in the Brooklyn Heights neighborhood, complaining, as his client had, that the lengthy legal proceeding had been unfair.

“All he wanted was justice and at the end of the day, he didn’t get it,” Mr. Lichtman said, adding, “It was a show trial, and it’s been so since Day 1.”

Moments later, Richard P. Donoghue, the United States attorney in Brooklyn, whose office prosecuted the case with colleagues from Miami and Washington, also addressed reporters.


Westlake Legal Group 17vid-chapo-still-videoSixteenByNine3000 ‘El Chapo’ Guzmán Sentenced to Life in Prison, Ending Notorious Criminal Career smuggling Sinaloa Cartel Prisons and Prisoners Politics and Government Guzman Loera, Joaquin Drug Cartels Drug Abuse and Traffic Brooklyn (NYC)

Joaquín Guzmán Loera, the drug lord known as El Chapo, was sentenced on Wednesday to life in prison plus 30 years.CreditCreditDrew Angerer/Getty Images

Mr. Donoghue said the authorities could not undo the misery Mr. Guzmán had caused, “but we can ensure that he spends every minute of every day of the rest of his life in prison.”

The trial took place under intense media scrutiny and tight security that involved bomb-sniffing dogs, police snipers and federal marshals with radiation sensors. The verdict on Feb. 12 came after more than a week of deliberations by the jury. Ultimately, Mr. Guzmán was found guilty on all 10 counts of the indictment.

Prosecutors leveled some of the most serious charges possible against him, presenting evidence that he sent hundreds of tons of drugs to the United States from Mexico and caused the deaths of dozens of people to protect himself and his smuggling routes.

The case revealed in exacting detail the inner workings of the Sinaloa drug cartel, such as how it employed I.T. consultants and how it packaged its cocaine in rubber “condoms.”

But given the defendant’s fame and notoriety, the trial was also a boisterous legal circus, complete with a horde of international reporters, a steady trickle of curious “narco-tourists” and a cameo appearance by an actor who plays the drug lord on a Netflix show.

The American authorities began their hunt for the kingpin as far back as the early 1990s, when he was indicted on separate federal charges in Tucson and San Diego.

The two indictments were filed just before and somewhat after he was arrested while on the run in Guatemala and then returned to Mexico, where he was tried and imprisoned for the 1993 murder of Juan Jesús Posadas Ocampo, a beloved Roman Catholic cardinal.

In 2001, however, Mr. Guzmán broke out of prison — by many accounts, in the bottom of a laundry cart — and spent the next 13 years playing cat-and-mouse with the law.

He evaded both arrest and the five subsequent indictments filed against him in the United States, largely by shuttling among a series of hide-outs in the Sierra Madre mountains in the Mexican state of Sinaloa.

In February 2012, the Mexican and American authorities came within inches of nabbing him in an ocean-view mansion in Cabo San Lucas, Mexico.

But he was not caught until Mr. Donovan and a coalition of law enforcement and military officers on both sides of the border mounted an wiretap operation that cracked Mr. Guzmán’s communications network. He was found in a beachfront condominium in Mazatlán, Mexico, in February 2014.

Within a year and a half, however, he had escaped again — this time, through a sophisticated tunnel that opened into the shower of his prison cell. A coalition similar to the one that caught him in 2014 redoubled its efforts and captured the kingpin for a second time, after a violent gunfight, in Los Mochis, Mexico, in early 2016.

When Mr. Guzmán finally stood trial in New York in November, his conviction was all but assured given the mountains of evidence collected against him over the years.

Some of that evidence came from incriminating intercepts from the various wiretaps over which agents had for months been listening in on the kingpin and his underlings. But just as damaging were the 14 witnesses from inside his cartel — suppliers, distributors, top lieutenants, even one of his mistresses — who testified against him.

Since his extradition to the United States in January 2017, Mr. Guzmán has been held in 10 South, the maximum-security wing of the Manhattan federal jail. On Wednesday, he told Judge Cogan that since arriving there he had been forced to drink “unsanitary water” and wear earplugs made from toilet paper to drown out the racket of the ventilation system.

In response, Gina Parlovecchio, a federal prosecutor, said it was ironic that Mr. Guzmán had complained about undignified treatment in jail given that he showed no respect to his countless victims, not just those he killed or hunted, but the thousands who were harmed by the drugs he “pumped onto the streets,” earning him a vast fortune of “blood money.”

One of those victims, Andrea Velez, spoke out in court on Wednesday. She described through her tears how Mr. Guzmán had paid a Canadian chapter of the Hells Angels $1 million in a failed plot to murder her. Ms. Velez was at one point the personal assistant to one of the kingpin’s top lieutenants, Alex Cifuentes Villa, but eventually became an F.B.I. informant who spied on the drug lord and his allies.

“I’m a miracle of God,” Ms. Velez said, “because Mr. Guzmán tried to kill me.”

Emily Palmer contributed reporting.

Read more about El Chapo
The Epic Criminal Career of El Chapo Nears Its Final Chapter

July 16, 2019

El Chapo Earned $12,666,181,704, Prosecutors Say. They Want Him to Pay It Back.

July 7, 2019

El Chapo Is Behind Bars, but Drugs Still Flow From Mexico

Feb. 13, 2019

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She Was Duped and Shipped to a Brothel at 16. Then the Boat Sank.

CHAGUARAMAS, Trinidad and Tobago — She slipped out of the house around dusk, without telling her mother. Sixteen and hungry, she followed the men who had promised her work and food.

Instead, they smuggled her out of Venezuela by sea, secretly planning to force her into a Trinidad brothel.

Put in a fishing boat, the girl, Yoskeili Zurita, said she sped away with dozens of other women, including her cousin. But the overloaded skiff took on water fast — and capsized with the roll of a sudden swell.

Screams pealed across the water. Women cried out the names of children they had left behind. In the darkness, someone prayed.

“My cousin didn’t know how to swim. She looked at me and said, ‘I can’t do this,’” recalled Yoskeili, who spent two days clinging to the overturned hull in the strait between Trinidad and Venezuela before fishermen found her. She never saw her cousin again.

The boat sank with 38 passengers in late April, most of them women. Only nine people survived, among them Yoskeili and other women who the authorities now say were victims of a human smuggling ring.

The tragedy was shocking even in Venezuela, a nation accustomed to the ravages of a collapsing state, hunger, hyperinflation and rampant crime. For millions, survival means leaving, whatever the risk may be.

In the last four years alone, about four million people have abandoned the country, the United Nations estimates. They leave on foot, crossing a treacherous pass in the Andes Mountains. They sell their hair in plazas in border towns, huddle in refugee tents in Brazil and Colombia.

And they head off in leaky boats short on gas or spare parts — and sometimes get lost at sea.

As the women in Yoskeili’s boat fought to survive, their state was nowhere to be found. The government, crippled by corruption, mismanagement and American sanctions on its oil industry, told relatives the day after the wreck that it lacked even the fuel to mount a rescue. A state helicopter arrived four days late to join a search that had been left mainly to local fishermen.

And Venezuela’s National Guard likely played a hand in the deaths: Venezuelan prosecutors have charged two soldiers for being part of a criminal group that tried to smuggle the women to Trinidad.

Then in May, while the country was still coming to terms with the disaster, the tragedy repeated itself: Another smuggling boat sank into the waves with 33 passengers aboard, including at least three minors. Only the captain survived, disappearing before the police could question him.

“How can this be allowed to happen again?” said Salvador Díaz, whose daughter had been on the boat with Yoskeili, hoping to reach Trinidad, when it sank.

Yoskeili now passes days alone in her room, at times wondering why she survived when so many other women drowned at sea.

One of them, Carmen Lares, a single mother, first lost her job this year, then lost her 3-month-old baby to malnutrition at the start of April as food ran short. Now she is gone as well.

Yoskeili replays the night over and over in her mind, remembering the crash of the waves against the hull, the women who couldn’t swim and took off their clothes in the frantic hope that it would help them stay afloat, and the promises of the men taking her to Trinidad.

“They said when we got there, there would be plenty to eat,” she said.

ImageWestlake Legal Group 4ca583f01bcf41adaa1d53197615f4c4-2-articleLarge She Was Duped and Shipped to a Brothel at 16. Then the Boat Sank. Yoskeili Zurita Venezuela Trinidad and Tobago smuggling Shortages prostitution Politics and Government Maritime Accidents and Safety Immigration and Emigration human trafficking Deaths (Fatalities) Corruption (Institutional) Caribbean Area

A half-empty supermarket in Cumana, Venezuela. As the economy has collapsed after years of corruption and mismanagement, shops have shut down and millions left the country.CreditAdriana Loureiro Fernandez for The New York Times

Mr. Díaz was slowly watching his family disappear.

First his younger son, a petroleum engineer, left to Brazil, crossing treacherous borderlands controlled by criminal groups. Suddenly his 22-year-old daughter, Oriana Díaz, was talking about smuggling herself into Trinidad.

He never imagined anything like this. Until recently, he had enjoyed a middle-class life as a public high school teacher. His other son was an accountant. The family used to vacation around the Caribbean, not flee there.

But food was in short supply. Domestic production had collapsed and the few imported foods on the shelves had become unobtainable ever since hyperinflation had destroyed his salary. His daughter was a single mother with two children to feed, ages 5-months-old and 2.

“I would leave the food for my wife and daughter, and I would go to sleep with none,” said Mr. Díaz. “This is what is happening in Venezuela, the parents stop eating to give food to our children, our grandchildren.”

So when Oriana said she would head to Trinidad to send money back to the family, her father felt he couldn’t object.

“I took her 2-year-old to the football field that was beside our house so he wouldn’t see his mother leave the house,” said Mr. Díaz.

In another part of town, Héctor Torres, recently penniless after he lost his job at a soda factory, was busy recruiting teenage girls for his first attempt at smuggling women to the island.

Mr. Torres tried to hide the true purpose of the journey, asking his sister, Eloaiza Torres, to take the women and girls into her house until the boat left.

“These are some female friends who are coming to Trinidad,” Ms. Torres recalled being told. She said the group included two minors.

Yoskeili said she was approached by a smuggler named Nano while she sat on her porch with two of her cousins. He gave her very little time to decide; the boat was leaving the next night and Nano — later identified by Venezuelan prosecutors as Dayson Alexander Alleyne, a 28-year-old now under arrest for human trafficking — promised plenty of food at the end of the journey.

Yoskeili didn’t tell her mother, fearing she might stop her, and confided only in her aging grandmother that she planned to go.

At 7 p.m., Nano arrived in a car, shoving Yoskeili inside and speeding off to a hotel where she was put into a room with other girls, she said.

“We’d been kidnapped,” she said. “They didn’t want anyone to see us.”

Evening fell on the Venezuelan fishing town of Güiria, where at the end of a pier a boatman prepared the skiff for the trip. Yoskeili’s fear became much more intense when she asked the other women what kind of work they would do on the island.

“All the girls on the boat said we were going to be prostitutes,” she said.

Others were just as surprised. Yubreilis Merchán, a hair stylist, believed she was being taken to see her mother in Trinidad. But women and girls kept being loaded aboard.

Yubreilis Merchán, 22, a survivor, recalled passengers’ fears of overloading the boat. “We were saying: ‘There’s water coming in the boat,’ and the boatman just said this was normal,” she said.CreditAdriana Loureiro Fernandez for The New York Times

“We were so many. We were saying, ‘There’s water coming in the boat,’ and the boatman just said this was normal,” she recalled, adding that the women at first tried to bail out the boat as they were crowded on.

Packed with 38 people, heavy motors, suitcases and contraband merchandise, the boat — named the Jhonnailys José — finally took off around sunset, April 23. The night was clear in Venezuela. A quarter moon was set to rise after 10:30 p.m., which would help the boatman see along the roughly 45-mile route.

But the waves were getting rough. Some smashed into the hull, and the boat came down with a thud down over large swells.

Then the motor went dead.

Without power, the Jhonnailys José was tossed, turning perpendicular against the waves. One overtook the boat, crashing inside. The boatman fumbled with a backup motor and the boat lurched.

“We started to scream, ‘We are going to sink!’” recalled Ms. Merchán.

Terrified, the passengers forced him to turn back for Venezuela with the backup motor as the boat continued to take on water. The women threw suitcases into the sea and bailed out water with their shoes.

It was too late. The water had engulfed the boat. It sank into the waves before flipping over.

“I thought of my daughters: I have three girls, one that’s 5, another 3, another who turned 7-months-old the day that I left,” Ms. Merchán said. “We were in a state of total desperation.”

She tried to hold onto a gas canister, but it leaked fuel that burned her face. A smuggler barked orders while some of the women who couldn’t swim crawled on top of the ones who could, in a frenzied attempt to breathe, Ms. Merchán said.

In the pandemonium, she saw one woman trying to escape the rest.

“I said, ‘Where are you headed?’” she asked. The woman signaled toward a rocky outcrop in the straits.

Lifted by a current, the two women pushed away from the capsized boat, holding hands under the water so as not to lose one another as the voices of their fellow passengers grew distant. After a long time, they heard the sound of surf beating against the rocks of Patos Island.

Ms. Merchán waded ashore, exhausted. Her mind suddenly flashed to her friend Yocelys Rojas, whom she had left behind at the boat.

Before they had set off that night, her friend was itching to share some news about her family back in Venezuela. But the loud motor had drowned out her voice, and Ms. Rojas was saving the story for the other side.

“She disappeared and I will never know what she was going to tell me,” said Ms. Merchán.

Fisherman resting in La Playita, in Güiria, Venezuela, at a dock frequently used to travel to Trinidad.CreditAdriana Loureiro Fernandez for The New York Times

In Trinidad, a bar owner in the capital, Port of Spain, got word that the women never made it to shore.

He had paid $300 to the smugglers to take one of the women to his bar, where she would work as a prostitute, he said. He had also paid a bribe to members of the Trinidadian Coast Guard so that they would not stop the boat, he said.

But no one showed up that night, said the bar owner, who asked that his name be withheld to discuss details of the crime.

Venezuelan radio had begun reporting the shipwreck. But as is often the case in Venezuela, where blackouts are rampant, there was no electricity in much of Güiria that day.

Mr. Díaz, the teacher whose children were steadily leaving for uncertain futures abroad, was sitting with his grandchildren outside to escape the heat when his phone rang.

“They said that the boat my daughter was on had flipped,” he said.

Mr. Díaz went to the harbormaster’s office. Dozens of other relatives of the missing had gathered to check on the search for survivors.

But nothing had begun.

“They said there was no gasoline,” Mr. Díaz said.

His anger rising, Mr. Díaz went to the Coast Guard office, which told him it hadn’t been authorized to perform a search, he said. Relatives of other victims say they had also been dismissed, encouraged to find fuel to mount their own improvised rescues with local fishermen.

The town mayor arrived, saying a helicopter would arrive, residents said. It didn’t come until four days later, they said.

Mr. Díaz stayed up all night, working his phone to see if any fishing boat could search for his daughter, Oriana. Sometime after midnight, he got word from his son-in-law that a boat was available.

But when he arrived at the pier at 3 a.m., he discovered the boat had neither fuel nor motor oil. Frantically, Mr. Díaz searched the town but could find only oil. Eventually, someone found gasoline, but just five gallons, not enough to get them back to land.

It was sunrise on April 25, two days after the boat capsized. Even though Venezuela has the largest proven oil reserves in the world, the government vessels were still short on gasoline. Fishermen used their own money to mount the search.

Drivers waiting in traffic and road blocks in the Venezuelan state of Sucre, where gas shortages are commonplace and affect everything from transportation to cooking.CreditAdriana Loureiro Fernandez for The New York Times

One man returning from a rescue attempt told Mr. Díaz that they had found only bodies in the water, which they had loaded onto a boat headed back to Venezuela.

“My heart crumpled,” Mr. Díaz said.

Out on Patos Island, Ms. Merchán was desperately seeking help.

After wading ashore, she had seen fishing vessels passing, but none had stopped. She was exhausted and could barely scream. At night she could see lights she believed were those of search vessels.

“We went on our knees, we prayed to God, screaming,” she said.

Ms. Merchán and the others took a risk, entering the water again to navigate the surf until they found a rocky outcrop that was more visible.

It was the right decision. Shortly after, a fishing boat pulled up with her husband and several other relatives looking for the victims.

“I just cried and cried,” she said.

In another part of the straits, Yoskeili said she had begun to hallucinate as she floated in the water, at one point thinking she had reached land.

She eventually fell unconscious floating near other passengers, as some were swept farther out to sea by currents. Two days later, she said she could feel the thudding of an engine in the water. A rescue boat arrived and dragged her aboard.

Back on shore, Mr. Díaz was convinced that his daughter had died.

But the same day the women were found alive on Patos Island, an ambulance with more survivors whooshed by. A fishing boat had found his daughter, Oriana, in the water, still breathing, near the wreckage.

“A boy said, ‘Professor, your daughter is here,’” Mr. Díaz said.

Oriana sat in the hospital bed, with gashes in her arms, her face and lips so burned from her days in the sun that she could hardly speak. She had no pants, having lost them at sea.

“She could have been missing an arm or a leg, but my daughter was alive,” said Mr. Díaz. He put a blanket around her as she asked for water.

“Just to think of this once more is to feel this agony and to know how one will never forget these times,” he said.

A television showing a soap opera in front of an empty chair in the Velásquez’s home in Cumana, Venezuela.CreditAdriana Loureiro Fernandez for The New York Times

For Omar Velásquez, whose 15-year-old daughter, Omarlys, was aboard the boat that night, there was no reunion in the hospital, only the hurt that she hadn’t told him why she left — and the grief that she never appeared again.

On a recent day, he mulled over the many unanswered questions. How did an overloaded boat smuggling dozens of women manage to leave the port undetected by Venezuela’s Coast Guard? Why was there no fuel for the government rescue boats, and why was no aerial search mounted for days?

And above all, he asked: Would there ever be justice for what happened?

“There was a deep complicity of the government that was behind this,” said Mr. Velásquez.

Carlos Valero, a lawmaker in Venezuela’s opposition-controlled National Assembly, points to the arrests of the two national guardsmen as evidence that government employees played a hand in the smuggling ring. But an investigation he opened last month has gone nowhere, he said, blocked by the country’s ruling party.

Mr. Valero has focused his attention on Trinidad, where he says he has gathered evidence that Coast Guard and immigration officials were paid about $100 for each woman aboard the boat — payments to allow them to enter. Answers from the authorities in Trinidad have also been hard to come by, he said.

“It’s like these people don’t exist,” he said of the victims.

In Port of Spain, the bar owner who said he was bringing one of the women aboard the boat continues his business unperturbed. One night in May, at the bar he runs in the capital, he flipped through pictures of underage Venezuelan girls on a cellphone, sent to him over the messaging service WhatsApp.

He explained the arrangement he had with the Venezuelan women conscripted to work under him: He pays a fee to the boatman for their passage, confiscates their passports and returns them only after the women paid several times what he spent to have them smuggled, he said.

The arrangement worked with the help of the Port of Spain police and the Trinidadian Coast Guard, both of which received payments, he said.

The Trinidad government did not respond to written questions or requests for comment. Three commercial boat owners in Trinidad and a fourth in Venezuela confirmed that they had either made payments to smuggle prostitutes from Venezuela, or had witnessed such payments by other boatmen bringing women to Trinidad.

At the Port of Spain bar, police officers approached the owner, in plain view of several Venezuelan women who worked under him, and greeted him in front of a reporter.

“These are my friends, I know them well,” the owner said of the officers, smiling.

Relatives of the suspects in the human trafficking ring said their family members had been falsely accused by the surviving women; none of those jailed could be reached through the Venezuelan prison system.

For all his anger, Mr. Díaz now seemed most consumed by the question that had led his daughter to leave: How to get food. Hyperinflation has continued. The food shortages remain. And no one in the family has dared to cross the waters again.

“We had big hopes for her,” he said of his daughter, Oriana. “She would be able to support all of us in Trinidad.”

He took a deep breath and added: “But the cure was worse than the sickness.”

The sun setting over La Playita, in Güiria, Venezuela.CreditAdriana Loureiro Fernandez for The New York Times

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Mexico’s Crackdown at Its Southern Border, Prompted by Trump, Scares Migrants From Crossing

NENTÓN, Guatemala — The Aguilar family had been preparing since February to migrate north. They borrowed $2,600, made a down payment to a smuggler and set off from their home in northern Guatemala last week.

But at Guatemala’s border with Mexico, their smuggler had some bad news: Crossing into Mexico was too risky. A June 7 deal between the Mexican authorities and the United States to reduce migration had brought extra security forces to the border.

Mexico’s mobilization of its security forces has been halting, and for most of the past two weeks it seemed to fall short of the dramatic show of force that the government had promised.

Still, the deployment has already disrupted the usual flow of people and commerce passing over this historically porous border, and sown fear among migrants and their smugglers alike.

“We don’t know anything, whether this is a definitive change, or just for some time,” said Juan Alberto Aguilar, 27, who was traveling with his wife and their 3-year-old daughter. The family sat dejectedly in the central square of Nentón, a village near the Guatemala-Mexico border, waiting for the van that would take them home.

The deployment plan is part of a deal between the administration of President Andrés Manuel López Obrador of Mexico and the American government to thwart President Trump’s threats of potentially crippling tariffs.

ImageWestlake Legal Group merlin_156687870_a3960cc1-7663-4347-a2f6-bf00ffc109f1-articleLarge Mexico’s Crackdown at Its Southern Border, Prompted by Trump, Scares Migrants From Crossing United States International Relations Trump, Donald J smuggling Politics and Government Nicaragua Mexico Lopez Obrador, Andres Manuel Immigration and Emigration Illegal Immigration Guatemala Defense and Military Forces Central America

Soldiers working with Mexico’s National Guard standing at an immigration checkpoint in the state of Chiapas this month.CreditLuis Antonio Rojas for The New York Times

On Thursday, President Trump praised the Mexican president for his early efforts.

“The flow has very substantially slowed down,” Mr. Trump said. “It’s already had a big impact.”

In Ciudad Hidalgo, a bustling market town in Mexico near the southwestern end of the border, vendors say they have seen a significant falloff in business in the past two weeks. Most of their clients are Guatemalans who avoid paying duty on their purchases by returning illegally to Guatemala on rafts that ply the Suchiate River, which demarcates that section of the border.

“The people are scared to come because they fear that the government will come and take their merchandise,” said Mary, a vendor in Ciudad Hidalgo who asked that her last name be withheld for fear of government persecution. “We live from that commerce, eat from that commerce.”

Across the border, in Nentón, Guatemala, Silvia Avaja, 30, the owner of a general store, said she usually traveled to Mexico once every three months to buy products such as soap, deodorant and toothpaste. But the new security measures in Mexico had spooked her.

She, too, had heard that the Mexican authorities were seizing shoppers’ black market goods.

“I’m thinking of not going over there anymore,” she said.

But the effect of the deployment has been felt most significantly among undocumented migrants, who now see a more impenetrable Mexico.

Merchants crossing the Guatemala-Mexico border at La Mesilla, Guatemala.CreditLuis Antonio Rojas for The New York Times

Jonathan, 28, a Nicaraguan seminary student, said he fled his home after being subjected to government persecution and death threats following his participation in antigovernment protests last year. He first tried to settle in Costa Rica but, facing more death threats there, he flew to Guatemala and traveled by land to the border with Mexico.

He made it to Frontera Comalapa, 25 miles into Mexico, before the new migration-control measures brought his trip to a grinding halt.

“I never thought it would be like this,” he said, sitting in a soup kitchen one afternoon last week and considering the possibility that this was as far north as he was going to get.

Three Nicaraguan friends who had also made it to Frontera Comalapa had already returned to Central America to wait for a better moment to try to reach the United States.

But returning to Nicaragua, Jonathan said, was not an option for him. His goal was still to reach the United States, which promised a far better livelihood.

“I’m going to fight,” he continued, requesting partial anonymity because of his legal status in Mexico. “I’m going to do everything possible to get there.”

Guatemalan merchants resting by a border marker in Guatemala.CreditLuis Antonio Rojas for The New York Times

For now, however, he is weighing the possibility of applying for asylum in Mexico. Migrants’ advocates say many more Central Americans and others are opting to do this, as it is one of the few options left amid the crackdown.

Elsewhere along the border, entrepreneurs who make their living offering services to migrants have seen a drop in demand.

“Before there were even entire families crossing,” said Israel López Ordoñez, 52, a veteran raftsman on the Suchiate River in Ciudad Hidalgo. “Now, no.”

In the Guatemalan border town of La Mesilla, near Frontera Comalapa, Carmelo, 50, a money changer, said that several people he knows — including friends and family — have aborted plans to migrate north in the past two weeks.

“It’s not good,” he said of the new measures. “If a Guatemalan travels to the States, a lot of people here can live from that Guatemalan.”

Even migrant smugglers — responsible for ferrying many, if not most, migrants to the southwest border of the United States — are delaying or canceling trips north.

Soldiers working with Mexico’s National Guard waiting at an immigration checkpoint in southern Mexico this month.CreditLuis Antonio Rojas for The New York Times

Like the Aguilar family, Ottoniel López, 19, a Guatemalan migrant, found himself just shy of the Mexican border when his smuggler told him to turn around and go home.

He said he had set off on his trip, bound for the United States, knowing he might face a range of potential hazards, like fatigue, hunger and possible violence. But the Mexican government’s crackdown had not been part of his calculus.

“You always know that it’s going to be difficult,” he said here in Nentón, leaning out of the van that would take him part of the way to his home in southwestern Guatemala. “But now they said we could not pass because of all the blockades.”

The agreement with the Trump administration gave President López Obrador 45 days to prove that Mexico could reduce the number of migrants crossing into the United States. Mexican officials initially said they would send 6,000 members of a newly created National Guard force to southern Mexico to impede the northbound flow of undocumented migrants.

But the deployment has been uneven.

First, it kept getting pushed back. Then, Mexican officials backed off their initial promise to mobilize 6,000 National Guard members to the south, and instead said that the force would also include members of the armed forces.

Maximiliano Reyes Zúñiga, an assistant foreign secretary, said last week that only 40 percent of the total deployment would occur in the southern border states of Mexico.

Migrants climbing up the embankment stairs toward Ciudad Hidalgo, in Chiapas, Mexico, after arriving by raft from Guatemala.CreditLuis Antonio Rojas for The New York Times

But on Monday, Gen. Luis Cresencio Sandoval González, Mexico’s defense minister, said that the government had mobilized some 6,500 security forces in the southern states, including about 2,000 National Guard members. More than 14,000 additional security forces were deployed in Mexico’s north to help control migration, he said.

Officials in Chiapas also acknowledged that curbing illegal migration through the state, which shares a long border with Guatemala, would be extremely hard, if not impossible.

The mountainous region is crisscrossed by back roads and footpaths. And residents and others speculated that entrenched corruption among government officials who have abetted smugglers and migrants would not be eliminated anytime soon.

But the number of government roadblocks along some main highways in southern Mexico has increased, local residents say, and the migration authorities and security forces working with them seem to be more thorough in checking passing vehicles for undocumented migrants.

The authorities have also started the more ambitious work of combating the smuggling operations that are responsible for escorting many, if not most, migrants north.

Migrants’ advocates have warned that the crackdown could invite human rights violations, concerns that were underscored by the recent shooting death of a 19-year-old Salvadoran migrant who was riding in a truck bound for the United States border. Witnesses told investigators that men dressed in police uniforms and driving a police vehicle opened fire on the truck after it passed through a migration checkpoint in the state of Veracruz and sped away.

While National Guard members are still scarce in the southern border region, military forces, some of them outfitted with National Guard arm bands, have been newly mandated to conduct night patrols, and to question the occupants of passing vehicles and inspect their cargo.

Immigrants’ advocates anticipated that the increasing presence of security forces would continue to drive down the number of people trying to migrate north, but they expected that in time, the flows would rebound, perhaps through more remote and dangerous migratory pathways.

“It’s going to be like when Trump became president, and the rate of migration went down for several months, but then went back up again,” said David Tobasura, a Chiapas-based immigration consultant for the American Friends Service Committee. “This is not going to stop migration. Surely in a few weeks or months, it will go back up. It’ll be the same as it was before.”

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