A Call for Unity From Below

Dmitri Prieto

During those still recent days when my mom was sick (we never imagined they’d be her last few left…) we frequently had to go to the hospital in Santa Cruz del Norte, the small coastal town where we live.  We met many doctors and nurses there, some of them specialists in various branches of health sciences.

Our hospital (it’s not a bad thing to feel like it’s ours) has established several services: gynecology and maternity, pediatrics, surgery, stomatology, physiotherapy, orthopedics and a few others.  In addition, the emergency medical service unit sometimes brings in the victims of traffic accidents from Via Blanca, the highway that runs from Havana to Varadero and that crosses in front of our town.  The hospital has beds for in-patients, along with a good nursing service and attendants.

Back then, when my mom was sick, we heard the rumor that Santa Cruz’s hospital was going to be turned into a simple polyclinic and that all the specialized services would disappear.  Such a decision, taken centrally by the government as part of its new plan for budgetary resource optimization, was not initially discussed with the residents of Santa Cruz.

These residents (along with those of the bordering towns as well as people who travel up and down Via Blanca) would have to begin seeking medical attention in a large central hospital in the town of Güines, where “our” specialized doctors would also be transferred.

Güines is far away, plus the roadway is bad; it makes lots of turns and there’s no direct form of public transportation to get there (the “indirect” form is private and costs about 20 Cuban pesos).  The worst thing is that ambulance service is precarious; there’s no ensuring that a “case” would be transferred to the distant health facility in time.

In addition to the economic argument, the decision makers provided reasons based on the new administrative division whereby Havana Province is being cloned in two, each with its own government and administration.

A few days ago in Santa Cruz there took place the routinely-held Asambleas de Rendición de Cuenta (Accountability Assemblies) in which each community’s elected delegate reports to their constituents on the outcomes of their administration, thereby allowing the voters to monitor any problems of their representative.

In any case, the experience in the last assembly was unusual: Voters literally demanded that our district’s delegate reverse the decision to move hospital services from out of our province.  Though it was said they didn’t “understand” the sense of the measure, people understood all too well the fate of the town’s medical services if the specialized doctors disappeared and were replaced only by a polyclinic with doctors who were general practitioners.

The trips would multiply —as would the illnesses— to the point that some especially vulnerable people would find it impossible to travel to another municipality.  This was looming as an imminent threat.

The delegate took note of the situation and requested her voters’ support, because she would need their unity as well as that of other delegates for the request for a reversal to be effective in the deliberations in the Municipal Assembly (City Council).

From what I’ve learned, the exact same thing happened in all the town’s accountability assemblies.  In one of them, an old official tried to argue in favor of the measure, but her speech was quickly refuted by a voter in very simple terms: because of his job the official has a government car and a gasoline allocation.  The immense majority of Santa Cruz residents lack both.

I hope that this unity from below is effective in the vital battle for our medical services.