A shortage of staff in Cienfuegos’s hospitals requires future doctors to do it all.
14ymedio, Julio César Contreras, Cienfuegos, January 30, 2025 — When Lisbeth arrived at Paquito González Cueto pediatric hospital, toughened by her tenure at various polyclinics in Cienfuegos, she thought nothing in the Cuban health system could surprise her. A third-year medical student, she hoped, that one of the most prestigious institutions in the region would offer her a less harsh outlook, than that of other centers where she had completed her internship.
However, as a result of the drop in population, the lack of personnel is felt more acutely in the state sector with salaries that pale by comparison to those in private industry, and even more so in the health field, where the human factor requires an extra effort that isn’t rewarded at the end of the month. Public Health and Social Welfare has lost 44,200 workers between 2022 and 2023, according to the latest yearbook, published this year.
Of these, at least 32,000 are doctors, but the shortages are intersecting and student interns not only solve the shortage of doctors, but also resolve tasks for which they are overqualified.
Of those, at least 32,000 are doctors, but the shortages are intersecting and in practice the students not only make up for the lack of physicians but must also carry out tasks for which they are overqualified.
“During my shifts, I have escorted patients in wheelchairs and on stretchers. I’ve had to administer injections and even had to sweep the floor.
“During my shifts, I have escorted patients in wheelchairs and on stretchers. I’ve had to administer injections and even had to sweep the floor when no one else is taking responsibility for cleaning,” informs Lisbeth, who also cautions about a long-standing issue. Not only must the patients bring their own food if they expect to receive adequate nourishment, but so must the doctors, as she herself has during the months of her internship.
Unlike doctors or other health care providers, medical students cannot ask for leave or a transfer to another hospital if they don’t like where they are. Doing so could cost them their diploma or result in a serious reprimand. The obligation to remain wherever they’re sent also subjects them to excessive workloads and arbitrary orders from those in charge.
“Sometimes, after I’ve finished my shift, I can’t leave to go home and sleep, have a coffee or take a shower,” another young student interning at the University General Hospital Dr. Gustavo Aldereguía Lima told us. “As students we’re at the bottom of the pecking order; we’re asked to do everything from carrying buckets of water from the cistern to picking up food for the doctors.”
Instead of encountering professional challenges that would help him grow, the young student has had to clean bathrooms, climb on chairs to fix a suspended ceiling so it doesn’t fall on a patient’s bed, or bring light bulbs from home so he can use the bathroom at daybreak. “Sometimes I think I’m going to graduate as a repair technician instead of as a doctor.”
For her part, Lisbeth accuses her professional colleagues of trading patients for “bags of food and necessities.” “It’s as if they are indifferent to the suffering of others,” she states. “If they have a case, they will prioritize those who are ‘recommended,’ those that have ‘clout’ or bring gifts,” she complains.
“When we are treating a patient, I’ve also noticed that some of our professors merely indicate a clinical procedure without explaining to us the cause of the illness and the reasons for their decision. We are practically doing the job of the nurses, basically learning through the literature, which is at times outdated,” she explains. “Some of my classmates ask me to be less combative, saying we just have to pass our exams, but I’m not satisfied with that.”
Lisbeth has a few more weeks left to finish her rotation at Paquito González Cueto, with its crumbling physical structure that serves as a metaphor for what is happening within its walls. Her greatest fear is that a truly ill patient will come in, a child whose treatment will not abide tricks or improvisations. “How can I provide the family of that child with assurances that the child will receive the highest standard of care?” she asks herself.
With a vocation for medicine since her childhood, the young student sums up the tragedy of studying medicine with this observation: Her profession is a noble one, but she was destined to pursue it in the wrong country.
Translated by Cristina Saavedra
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