Havana Ambulance Service Crisis

By Fabián Flores (Cafe Fuerte)

HAVANA TIMES — With only ten or so of its 118 ambulances currently in circulation, Havana’s ambulance service is in extremely critical condition.

A recent meeting between Cuba’s Public Health Vice-Minister Marcia Cobas and several top officials of the Comprehensive Medical Emergency System (SIUM) analyzed complaints from the population, arising from delays in the arrival of ambulances around the city, and addressed the alarming drop in functional vehicles.

“Only 15 percent of the vehicles that make up the city’s ambulance fleet for the seven zones that SIUM services in Havana (North, South, East, West, Center, Boyeros and Cotorro) are operational. Many of the ambulances are in the auto-body shop or awaiting overhauls at the warehouse, because they have a lot of mileage but very little maintenance,” a Ministry of Public Health (MINSAP) official told Cafe Fuerte.

Another serious problem faced by SIUM is the lack of qualified personnel.

Lack of Personnel

“In some of the zones, there are as little as five teams of ambulance workers. They don’t have personnel willing to work for such low wages and under such poor working conditions. You could have 20 operational vehicles for one zone, but, if you don’t have professionals willing to work, this means nothing,” the official, who chose to remain anonymous, stated.

Each ambulance team is made up of a driver, an intensive care nurse and a paramedic. In Cuba, a paramedic employed by SIUM earns 355 Cuban pesos (around 18 USD) a month, less than the ambulance driver.

In June, the Cuban press reported on the situation of paramedics working as part of ambulance teams in Santiago de Cuba, who had their salaries reduced by 72 pesos (previously, they had been earning the amount paid to emergency vehicle drivers). Two MINSAP officials in Santiago de Cuba were penalized with a 25 % reduction of their salaries one month for having included the paramedics in the wrong wage category.

Ambulance drivers, however, aren’t satisfied with SIUM wages either.

“Many of the drivers have quit and taken jobs as private or State bus drivers. They stop driving ambulances because it doesn’t pay the bills. The same thing happens with the nurses, who quit their SIUM jobs to work at cafeterias,” the MINSAP official stressed.

An Avalanche of Complaints

An ambulance driver earns approximately 460 Cuban pesos a month (23 USD), while bus drivers are paid a salary of around 900 Cuban pesos and receive an occasional bonus, depending on the company they work for.

One of the complaints addressed during the meeting of ministry officials was that of a patient who had to wait nine hours for an ambulance (luckily, it was not an emergency). The population’s dissatisfaction with SIUM services is well-known, and is even expressed in comments left by readers at the web-site of the Party newspaper Juventud Rebelde.

Those who attended the meeting held to address the situation of SIUM proposed the decentralization of the annual budget and the payment of non-emergency services as a means of alleviating the crisis. The Cafe Fuerte source commented that they have planned a meeting with the Minister of Public Health and a report to Cuba’s top government officials.

SIUM was created in 1997. According to official data published in 2008, it began to offer services with a fleet of 117 ambulances in Havana, a city with over two million inhabitants. Of these, 23 were used for emergencies and were equipped with medical equipment for such purposes, 16 for minor emergencies and the rest for transporting patients between medical facilities.

In 2011, SIUM underwent restructuring and, by the close of 2012, there were 921 ambulances in the whole country. Around 6,500 medical workers then made up SIUM’s staff. As of then, the staff began to be reduced, according to official figures.