Cuba’s Public Health Budget and Rafael

By Fernando Ravsberg*

Rafael Botalin Diaz, 15.
Rafael Botalin Diaz, 15 years old.

HAVANA TIMES — Rafael Botalin Diaz is 15 years old and suffers from a high-grade cerebral AVM that could kill him at any moment. It was detected in April, when he experienced convulsions and blacked out for half an hour.

He was treated at the Santiago de Cuba Children’s Hospital. There, on determining the seriousness of the case, the Ministry of Public Health placed him on a plane headed for Havana, accompanied by his parents and a nurse that was to see him at the Neurology Institute.

Physicians in the capital confirmed the diagnosis and decided that, given the complexity and gravity of the condition, he could not be treated in Cuba. The teenager requires multiple embolizations and radiosurgery, in view of which they recommended sending him to Spain.

Rafael’s father explained to me that there is a commission that reviews each of the cases that must be sent abroad for medical attention. This commission approved the patient’s transfer to a specialized care center abroad.

All trip and medical expenses are covered by the Cuban Public Health Ministry. They include anywhere from 30 to 50 thousand euros for medical attention and the round trip tickets for the child and his mother. She is also given money for the hotel, food and transportation.

“I have no complaints about the medical attention my son has received, the problem is that the trip is being delayed and no one is giving me an explanation,” his father, whose name is also Rafael Botalin, tells me.

1.Rafael Botalin, fighting for his son’s life.
Rafael Botalin, fighting for his son’s life.

He explains to me that, after his first meeting with the official responsible for these types of cases, he has never again been able to see anyone. He adds that the few times he has managed to get this person on the phone, he has received a very curt reply: “we have no new information for you.”

Rafael has requested a meeting with the Vice-Minister for Public Health several times to get an answer, but he has never been able to get past the secretaries, who always tell him their superior is on vacation, at a meeting or simply away.

He said that, finally, one of the secretaries took pity on him and informed him, over the phone, that the true cause of the delay is that the year’s budget for sending patients abroad has run out and that he would have to wait until January of 2015.

Rafael again consulted with the doctors, who reiterated that the case is very serious and should be treated as soon as possible. The problem is that the malformation is very complex and is aggravated by the changes a person experiences during adolescence.

2.Rafael shows us all of the letters written to the Ministry of Public Health.
Rafael shows us all of the letters written to the Ministry of Public Health.

They explained to him that another episode like the one he suffered in April could cause permanent damage and even death. Getting no answers from the Ministry of Public Health, the father is writing dozens of letters – to UNICEF, the WHO and the Central Committee of the Communist Party, among others – but no one replies.

Finally, he wrote my blog, Cartas desde Cuba (“Letters from Cuba”), in an attempt to make the case public, believing that he is facing mere bureaucratic hurdles, unwilling to have his son’s life depend on that. “If the budget’s run out, then they should get the money from less important health programs,” he said to me.

“Cuba invests money to help couples who suffer infertility and I think that’s very good, but they can’t prioritize that over the life of children who have already been born,” he added, arguing with as much passion as reason.

Without a doubt, Cuba’s economic resources are limited and sending patients abroad to receive medical attention at the expense of the Public Health Ministry is commendable for a Third World country.

It is advisable for the different sectors of the economy to restrict their spending to a given budget, but there are some sectors, such as health and education, in which flexibility is of the essence, in order to avoid having a child die of a curable disease or be left without a teacher.
(*) Visit the blog of Fernando Ravsberg.

5 thoughts on “Cuba’s Public Health Budget and Rafael

  • Because things like this if why it is not wise to leave the life of citizens in the hands of the state. The state don’t produce richness under any existing political system. The state should be only the distributor of the richness created by citizens…… when the state takes the citizens’ tasks pretending in an absolute way to be the only richness creator then the country falls in an absolute incapacity to produce richness and becomes absolutely dependable of subsides from other countries ……. neither the state should take the roll of charity provider because as depender of other countries subsides the sate fails to provide charity when needed…….….. political systems like the ones in Europa, Costa Rica, Panama o Chile uses to solve problems like thi without direct intervention of the state ….. in these countries the state is just the distributor of part of the richness created by the people ….. that’s why castro’s system can’t solve Rafael’s problem but Spain can………. I got an idea right now!!!!!! …… castro regime can take some money from the very expensive propaganda campaign it drives around the world for the 5 spies and buy an insurance in Spain to guaranty the happy end of cases like Rafael’s…… I am sure such an insurance will be not as expensive as just a fraction of the money spent for the 5 ones……….. another source castro regime can find money for these extreme painful cases is limiting the expenses of Mariela Castro in Europe….. specially her investments in French Riviera real estate.

  • I seriously doubt that the medical facility CIMEQ where Fidel is treated and where Hugo Chavez received his treatment is unable to treat this boy. Even if they are, it would be easier to fly in the surgeon and the equipment than it is for a sick patient and his family to travel. The Spanish surgeon (or Cuban American as you suggest) could instruct the Cuban surgeon on the procedure and the treatment so that the next patient would not face the same issues. This is what happened to Fidel during his health crisis in 2006. A Spanish surgeon was flown in who allegedly brought the Cuban staff up the learning curve to treat the supposed stomach issues of the dictator. Of course, if the boy does not come from the family of a high-ranking military officer or member of the Communist Party, he has no access to this facility. Reminds me of what George Orwell said “All animals are equal, but some animals are more equal than others.”

  • In a place where resources of limited, there are discussions like this. IN the USA, where there is money enough for armaments and extra bridges, we seldom have such debates. it is positive to see these choices. Mr. Botalin makes a good point about the choice between his boy and couples seeking to have children

  • I pray the child will be able to get the necessary medical care as soon as possible. Perhaps he could be treated in Miami? It’s not so far as Spain and the costs would be less. Perhaps a Cuban American organization could raise the money to help pay for the medical care?


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