Health Care in Cuba: All That Glitters is Not Gold

I want to be objective. In Cuba very few services work properly. The economy is a disaster. The worst kind of bureaucracy is pervasive. A number of political freedoms are lacking. And the democratic process – which our leaders trumpet so loudly – is no more than a bad joke.

The public health service is an achievement of Fidel Castro. Let’s try to look at the pros and the cons of medicine in Cuba. Nothing is completely black and white.

Before 1989 the state health system worked three times better than in 2010. The former USSR subsidized the economy of the ‘Green Crocodile’ with sizable amounts of rubles and oil. The government built an efficient health service with full coverage for all citizens.

With the coming of the Great Cuban Depression, which has lasted for 21 years and is known in Party jargon as a ‘Special Period in Times of Peace’, there was a serious decline in the quality of the public health service.

The regime, however, tries hard to make it work. There are walk-in clinics, offering a wide range of services, in every town in the country. And several hospitals in each of the 14 provinces. The island has more than 70,000 doctors. There are many high level specialists. And in every neighborhood there is a chain of preventive medicine centers.

Pregnant women receive prenatal treatment comparable to that of a first world nation. Children are vaccinated against all kinds of diseases. And the elderly are given geriatric treatment.

Leftwingers of different continents, when they loudly applaud Castro, point out that in Cuba even the opposition is guaranteed proper medical treatment.

I fail to see why this should be any other way. No one, in any country is asked about their political or religious beliefs when they receive medical treatment.

It is true that the embargo presents difficulties for the government of the island when it wants to buy the latest medicines and sophisticated equipment made in the United States. But if they had money, they could buy these things in Canada or in any other country that makes them.

Although I’ve seen that in the pharmacies reserved for foreign currencies, you can find antibiotics and anti-inflammatory medicines from prestigious laboratories, and even Viagra. Cuba is an unusual country. Here what is normal is abnormal and vice versa. Basic services like street cleaning and drinking water barely function.

I acknowledge that the government does what it can to maintain an adequate standard of health care. But there are many failures. Ask the people who have stayed in Cuban hospitals. When this happens, people cross their fingers.

The reception rooms are dirty, and the structural state of most of the hospitals is terrible. It is a serious problem. Families have to provide fans, buckets, sheets, towels… The food given to the patients is disgusting.

The standard of the doctors has fallen dramatically. The best work in places like Cira García or CIMEQ, intended only for the care of Party leaders. Or they treat foreign patients.

High quality doctors are always looking for a ‘mission’ to Venezuela or South Africa, so that, after three or four years, they can return loaded down with household appliances and a fistful of dollars which makes their life much easier in the olive-green socialism of the Castro brothers.

Rampant corruption in Cuban society also affects the health sector. Some doctors will treat you like a king, when you offer them gifts under the table. Also in exchange for money, unscrupulous people who work in hospitals will sell you medicines that were received as donations.

There are worse things still. Like those mentioned by the BBC correspondent in Cuba in ‘Health Resources’, published in his blog.

On April 29, when the American journal Science published an article full of praise for the health system on the island, they were quite right. For a poor nation in the third world, the Cuban medical service is indeed a luxury.

The official doctors, involved in a campaign against the foreign press, which they accuse of attacking and denigrating the country, took a break, and Randy Alonso, presenter of the programme Mesa Redonda (Round Table), read the Science article with restrained emotion.

I don’t know whether the authors, Paul K. Drain and Michele Barry, were able to visit freely public hospitals in different provinces on the island.

In any case, it is hardly to be expected that an American journal should recognise the positive aspects of the Cuban health service.

Although all that glitters is not gold.

Iván García