The Two Faces of Medicine in Cuba / Iván García

Photo: Room with two beds and two armchairs in CIMEQ for the patient and a companion.

Dennis, 39, and his wife Elvira, 37, spent seven months trading off between sleeping on the floor and on a mat full of patches, next to the bed of their 10-year-old son, who was involved in a complex surgery at the Juan Manuel Marquez Pediatric Hospital, located in Marianao.

They have relatives in Havana, but their home is in Cardenas, Matanzas province, 140 kilometers from the capital, and for years, due to the precarious health of their only child, they have lived somewhere between the two cities.

The Marianao Pediatric hospital, freshly painted, seen from the outside does not look it, but it needs a careful building maintenance. The corridors leading to the neurosurgery room are completely dark.

The few air conditioners that still work leak water that floods the halls. When a child is admitted, families have to carry buckets, toiletries, televisions and food.

The hospital does not guarantee these supplies. Food intended for patients and those with them is a real hodgepodge. “The least bad is the medical staff, they are industrious and capable, but if you want to get good care, you bring gifts and snacks to every consultation,” says Dennis.

Also scarce are the latest drugs. The doctors in Cuba usually have two types of treatment, depending on the patient’s pocket.

If you’re short of money and have no relatives outside, you are prescribed drugs sold in pharmacies in the national network, usually of low quality.

If you tell them you have relatives across the pond, in the United States or other countries, the doctor offers a wide range of advanced drugs. The Cuban doctors have Internet and are quite well-informed.

Alternatively, if you receive remittances from friends or family abroad, or have access to foreign exchange, you can purchase in hard currency, in any of the dozen scattered International Pharmacies in Havana. They sell a wide range of drugs produced in the capitalist laboratories capitalists.

If the Marianao Pediatric urgently needs a hand, what about the other centers in Havana. When you visit dilapidated hospitals like the Miguel Enriquez in Luyano, or the ancient Dependientes, on 10 de October Street, you will miss the tiresome governmental discourse that tells us that Cuban public health is one of the best on the planet.

Also needing a standing 8 count are several rooms of the Calixto Garcia or Emergency, on Avenue Charles III. The floors and bathrooms with no sanitation, peeling walls, leaking roofs, rude manners of a segment of the nursing staff, shortage of surgical instruments and little professionalism in some physicians, have resulted in health care in Cuba that is currently in free fall.

When an ordinary citizen should be hospitalized or receive extensive treatment, cross your fingers. Many brilliant specialists are serving abroad.

And those left to fill those positions, are overworked. Add to that a doctor on the island, on average earns a monthly salary equivalent to $30, breakfast coffee without milk and they sometimes have to spend two hours in a crowded stop to board the buses that take them to the hospital or clinic, then the best option is to not get sick.

Norge, 28, with chronic asthma, wants to be well treated and so he became friends with the doctors and nurses treating him. “Whether I’m seeing them or not, I visit them and give them gifts. Once, I gave each a leg of mutton.”

If most of Havana’s clinics and hospitals are crying for maintenance, you can not say the same of Hermanos Ameijeiras Clinical-Curgical in Central Havana, within walking distance of the Malecon.

This hospital is in good technical condition and a simple look around notes the hygiene. One reason may be that is one of the flagship institutions of public health in Cuba, in addition to having several floors devoted to the care of foreign patients.

But if you want to see clinics like those you see in the U.S. TV shows transmitted on national television, look at the Cira Garcia Central Clinic or the Center for Medical-Surgical Research — the famous CIMEQ — both located in Playa municipality.

You will first see rooms that are conspicuous by their cleanliness, a quality balanced diet, a fleet of well equipped ambulances, security guards and top-flight doctors. All to be paid for in dollars, euros or pesos convertibles.

The ministers and generals are entitled to be treated at these clinics. Or foreign leaders like Hugo Chavez, operated on three times at CIMEQ, to stop the cancer he suffers.

For them, Cuban health care is a real gem. Dennis and Elvira, who have spent seven months sleeping on the floor of a pediatric hospital, think otherwise.

March 22 2012