Popular Havana “Pain Clinic” Closed
Luis Rondon Paz
HAVANA TIMES — On June 30th, the Traditional and Asian Comprehensive Medical Clinic (CIMTAN), popularly known as the “pain clinic”, located in the town of Santiago de las Vegas, in Havana’s municipality of Boyeros, was shut down despite the efforts of workers and uncertainty for patients around the town.
Days before the clinic was closed, I paid the institution a visit to get to know what was happening first hand and to find out why high public health authorities had decided to close a center that offers medical services which do not entail significant State spending (most of them being based on natural and traditional medicine).
When I arrived at the clinic, I introduced myself at the reception and asked about the bad news. With an angry look on her face, the receptionist informed me the decision had been handed down by the Provincial Public Health Office. I then approached a number of patients. They were disconcerted; for they didn’t know where they could go after the clinic was shut down.
“I’m in treatment, there’s still a month left and no one’s informed me where I should go to continue my therapy,” said an elderly woman who was sitting outside the reception, waiting for her turn.
The discomfort was apparently common to patients and employees. When I asked the receptionist if I could speak with the director of the clinic in order to obtain more information about the decision, I was denied permission. She said that the management was not authorized to give me that information.
“Is what’s happening here a State secret?” I asked. “If not, then, explain this to me.”
Minutes later, I met Dr. Nelson Garcia Rodriguez, the Municipal Public Health Coordinator. He briefly explained the situation to me. “The story behind the clinic being shut down dates back to 2010. The program failed,” he said to me.
He went on to describe, in his own words, the role played by natural and traditional medicine practitioners in family clinics and polyclinics. Since there was a shortage of personnel at the time, these were assigned to other areas unrelated to their profession. This left patients receiving this kind of medical attention without treatment. According to him, this problem has not yet been overcome. He expounded on this on November 11, 2010, in a “report” where he made recommendations about natural and traditional health services in the municipality of Boyeros. He added that, today, they face the same problem they did 4 years ago.
I decided to look into what opinion people had of these services at the Santiago de las Vegas polyclinic and the Public Health Workers Union in the municipality of Rancho Boyeros. When I got in touch with Ramon Rivas, Head of Population Services, he told me to phone the Municipal Health Office in Fontanar, where they could offer me more information on this matter. He told me he was being bombarded with complaints by workers of CIMTAN and people who were receiving treatment there.
Before calling the Provincial Health Office, I called the municipal health workers union and was informed that “the measure was taken at management level and the union had no authority to intervene before a decision of that nature.” They suggested I call the Municipal Health Office, which is what I did when I hung up. Unfortunately, no one picked up at the number they gave me, so I decided to call someone higher up to see if I got an answer different than the one given me by the director of CIMTAN.
After calling several offices of the National Public Health office, I was redirected to the Population Services Department, where they noted “my concerns.” They said goodbye promising to “convey my comments to the responsible entity.”
Two hours later, I again gathered up the courage to call the Municipal Health Office. I got someone on the phone this time around. I asked my questions about the “pain clinic” over the phone. Judging from the tone of the woman’s voice, she was not too pleased to talk about this, for all of her answers repeated the argument that “the closure of the clinic had to do with the restructuring of Public Health institutions, undertaken as per the Party Guidelines.” She hung up without giving me another explanation.
The following day, I talked to delegate Jaime Antonio Toledo and found out that, on March 17, Dr. Nelson Garcia had sent a letter to the Population Services Office of the Council of State, the Boyeros Municipal Health Office, the Ministry of Public Health, the Provincial Public Health Office, the Boyeros People’s Power Bureau and the Boyeros branch of the Cuban Communist Party (PCC), hoping they would address CIMTAN’s problems, as per the right granted its employees by Article 63 of the Constitution.
A month later, he had only gotten a reply from the Provincial Health Office, through an official responsible for natural and traditional medical services in the province. According to Nelson, before the union of the institution, the chair of the People’s Council, Noel Perdigon, delegate Jaime Antonio Toledo and the clinic’s director, Dr. Maria Asuncion Tosar, they were led to believe that the clinic would not be completely shut down. Some delegates there even calmed people down saying the clinic would not disappear.
“We’ve been lied to,” Jaime remarked. “The employees of CIMTAN and the town residents were told they were not going to shut down the clinic, and they did precisely that!”
According to data provided by Jaime, in its 17 years of operations, CIMTAN treated a total of 306,766 patients. In 2013, it treated a total of 24,820 patients, administering a total of 96,284 treatments (2,281 patients per month, 570 per week and 102 per day).
The clinic offered courses to dentists, medical doctors and nurses and private training courses for foreigners.
On June 18, in protest over the closure of the clinic, Nelson sent out a letter titled “Yes to restructuring, no to closure.” It was addressed to the Municipal Health Office, with a copy sent to the Canal Habana TV station, the Ministry of Public Health, the Boyeros Municipal Health Union, the Boyeros branch of the PCC, the Boyeros People’s Power Office and the Council of State. He has yet to receive a reply from these institutions.
A great story, Luis Rondon Paz! Your experiences–not to mention those of the patients served by this clinic, and the medical staff who serve them–are positively “Kafkaesque!” The run-around you received reminds me of the “treatment” I received a few years back from my “HMO.” I had had the temerity of becoming sick at a distance–2000 miles–from my “authorized” medical providers. It took me more than a year of e-mailing, calling and visiting various HMO bureaucrats, plus paying a significant portion of my bill out of pocket (and, of course, never being re-imbursed), before I found limited satisfaction.
In the U.S., just the opposite is true. Travelling to my 50th high school reunion in South Florida back in 2011, there were about a half-dozen drug addicts on the bus upon which I was travelling, heading for Miami; all were from up North, and all were heading to store-front “pain clinics” in Miami to score Oxycontin and other controlled pain substances in order to take the pills back North to resell to their friends. What a world!