Barranquitas is a fishing village on the shore of Lake Maracaibo, in the state of Zulia in Venezuela. Many of its streets are unpaved, the houses lack plumbing facilities, and sewage runs in the open gutters. In addition to this alarming poverty, the villagers have suffered for more than one hundred years from a particular genetic disorder. Barranquitas is a major focus of Huntington's Disease (popularly associated with the condition of Saint Vitus Dance, el Mal de San Vito in Spanish), a rare, hereditary, neurodegenerative disorder, for which there is no cure. 'El Mal' is a photographic essay about the ravages of this terrible disease in Barranquitas. The stories in the essay show people's struggles with the condition and their will to live, in spite of the end to which they are condemned, in a hostile environment, without proper food or medicine, in the midst of appalling poverty.