14ymedio, Luz Escobar, Havana, 15 July 2019 — First there was the fever and then the rash broke out. The nine-year-old girl arrived at the 19th of April Policlinic in Havana at noon, last Tuesday. She was diagnosed the minute she crossed the clinic threshold: “That is dengue, she will be admitted,” said the emergency room doctor categorically.
The little girl had been infected with the annoying companion that these days spreads through the neighborhoods of the Cuban capital. Dengue fever, the viral disease inseparable from the warm months on this island, crowds the consultations and the hospital wards, without official announcements or national statistics about its presence.
After being diagnosed, the girl waited with her mother to be transferred to the Marfan Municipal Pediatric Hospital, in an ambulance that took more than an hour to arrive. Inside the vehicle there was only one rickety bench and none of the resuscitation equipment that “appear in the movies,” the little girl pointed out with disappointment.
After one o’clock in the afternoon, the entrance hall to Marfan Hospital was a hive of people. Mother and daughter were accompanied from the clinic to avoid the admitting area, a widespread practice among those who do not want to stay in a hospital center where the material conditions, the heat and the bad quality of the food complicate the stay.
The doctor on duty, who at that time was taking care of two other patients, asked “And what is this, another inpatient?” And immediately added that the hospital had no beds available. A few minutes later, a space opened up in one of the rooms and the patient received her sign-in form, although she still had a long way to go.
After several blood tests, the mother took all the papers to the reception but the employee who had to complete the process was having lunch. When he returned, 45 minutes later, the pen had been stolen and he took another half hour to fill out the documents. The girl was sweating buckets, because the air conditioning in the hospital was broken.
With the delay, the bed that had opened up became occupied again and the patient was left in a bureaucratic limbo: she had the hospitalization papers but there was no room for her. Finally, at three o’clock in the afternoon, a possibility arose. Mother and daughter went to the fourth floor, where most of the patients were “suspected of dengue.”
The actual numbers of how many people have been infected by this virus are difficult to pin down. Some never go to the hospital for fear of being admitted, others have mild symptoms and by the time they realize what it is the worst has passed, and there is no lack of those to prefer to appeal to a contact in a polyclinic or hospital to get tested ’under the table’ and find out through the platelet count if they have been infected.
With the abundant rains of recent weeks the presence of the Aedes Aegypti mosquito, the main carrier of the virus, has increased. In addition, unlike other years, the vector campaign to control the mosquitos has not been as intense as in the past, due to the economic problems that the country is going through which have forced cutting back on inspectors and fumigation.
Every patient diagnosed and admitted is only part of how dengue affects the life of a Cuban family. Shortly after the girl was hospitalized at the Marfan, the father, grandmother and other relatives showed up, carrying everything from bottles with boiled water to food, a fan, a bucket, sheets and towels.
This time they were lucky, because in the bathroom of the room there was no lack of water and the plumbing worked. A true miracle. “I have been transferred from another hospital and there was no water there,” says the mother of a girl who was placed in a nearby bed. “The food is not bad, but it doesn’t taste good,” warns the grandmother of another patient.
Underneath mosquito nets*, with the fans that they brought from their homes and with laptops, tablets or mobile phones — providing alternatives to the boring TV programs — so the children spend their time. From time to time, doctors arrive to evaluate them, take their temperatures, and report if a bed has been freed up so those waiting below can go up and go to bed.
Day and night, family members of the sick share stories in the hallways about the other hospital centers. Everyone has some anecdote to tell about the delay, the problems and the shortcomings. The rooms become small parliaments, much closer to the reality than the discussions of the National Assembly which, just at that time, were underway a few kilometers from Marfan Hospital.
Each and every one of those who remain there counts the days, the hours and the minutes until they can leave. On the second day without a fever, the girl receives a medical discharge. The family packs up the makeshift camp they had assembled with belongings brought from the home. There are laughs, farewells and a gesture towards the patient from the neighboring bed who inherits a bar of soap and a piece of bread.
The little girl receives a paper to present to her local clinic and bed rest is recommended. From the polyclinic in her neighborhood they send a fumigator to the house to “eradicate any focus.” A day earlier, in the Parliament, the vice-head of Epidemiology of the Ministry of Public Health, Regla Angulo, had reported that there were outbreaks of dengue in several areas of the country, but he gave no data, no figures, no details. Nothing.
*Translator’s note: Dengue patients themselves are a major vector in spreading the disease, infecting mosquitos that bite them and get infected and then pass the virus on to others.
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