Chinks in the Armor

Rosa Martinez

Hospital photo by Isbel Diaz.

HAVANA TIMES, Nov. 12 — “Cubans complain a lot about health care because it’s free.” Those were the words of a physician, who’s a friend of our family, when I told her, “Maria, every day I hear more negative comments from people related to health care services, especially concerning doctors.”

She added that those people who complain so much about health care in Cuba should go to any Latin American country for a few weeks to see the thousands of children who die from illnesses that are not even known of here in Cuba, or they should consider the thousands of dollars it costs for the simplest operation.

“You even have to pay for a blood test,” she continued.  “When I was in Guatemala I heard about numbers of cases where people died in private hospitals because they came in injured or with a serious illness but didn’t have medical insurance or money.  They simply didn’t get treatment.  Maybe if people here saw everything that happens with health care in the rest the world they’d protest a little less and give thanks a little more,” she said, visibly upset with the topic of conversation.

Maria is a doctor, and of course she doesn’t care for anyone speaking poorly of the field that she defends with such love, labor and sacrifice.  It’s true that our health system is one of the greatest achievements of the Revolution that triumphed in 1959.  This is not only because it’s “free” to the public —though it costs a lot— but also thanks to the considerable resources invested in the training of medical personnel, paramedics and the nation’s overall health infrastructure, which can be compared with that of any developed country in the world.

Recently many millions of dollars have been invested in repairing existing public health clinics, opening new ones, training personnel and producing medicine while always seeking excellence in service with state-of-the-art technology.

Thousands upon thousands of Cuban professionals raise the flag of internationalism as they lend their services in dozens of nations around the world.  They work in the most far-flung regions of the planet displaying their professionalism, human sensitivity and total commitment to the human species.

I remember a recent report on TV in which a doctor from Matanzas province talked about the miles she had to travel daily in the jungles of Bolivia and the dangerous trips she took by canoe while faced with the danger of the numerous illnesses in that region.  Nonetheless, her overall sense was that of great satisfaction with being able to help that fraternal but less advantaged nation.

The problem though is when the same thing doesn’t happen to you: when you go looking for a specialist in your area of health concern and you can’t find them; when you’re mistreated by a doctor trained at no cost to them (though indeed by the public) in a health institution built by that same public.

Only a few days ago I needed the services of an urologist at the Dr. Agostinho Neto General Educational Hospital in the city of Guantanamo.  Several specialists were having a friendly chat in reception area and exchanging pleasantries.

“Good morning,” I said.

“Yeah, right,” the five men responded without looking at me.  They didn’t even let me explain what I wanted.  They continued in their enthusiast conversation preferring not to pay any attention to me, the intruder.

I was there almost two hours, but the urologist never came.  On the first floor more patients were also waiting for that doctor.  They, just like me, would have to go home and come back another day hoping for better luck.

A neighbor of mine told me about how her daughter was in need of psychiatric care and that she had asked for a new prescription from the specialist because the one she had wasn’t helping.  The response she got was that “only those who bring something [a gift] can ask for anything.”

The wife of my uncle turned out to be diabetic and was admitted into the hospital for more than 15 days.  She was discharged from the hospital with her glycaemia level still high but without having been evaluated by a clinician.  When I asked her how she had left without having received attention,  she told me that she had gone there and waited each day but the specialist never showed up.  After being there so long, she got tired and decided to go home.  “If I didn’t know you, I wouldn’t believe you,” I told her, astonished.

What is certain is that it is doesn’t matter that Cuba has guaranteed health services or that the nation is so proud for providing assistance to others in need if there are chinks and incongruities in the public health care system at home with rampant abuses or even unscrupulous doctors who demand bribes from their patients.

From what can be seen, Cuban health care excellence has blemishes that are becoming more noticeable.  This is generally ignored by the media, which remains silent in the face of the displeasure of the public that is forced to adopt attitudes like those described here, be accomplices or cut individual deals with medical staff.  The problem is that this is nothing more than playing with fire…

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2 thoughts on “Chinks in the Armor

  • Your commentary points, in my opinion, to the urgency of carrying through the economic reforms that have been proposed.

  • A superb article, Rosa. You placed Cuban healthcare in context and then pointed out some of its “blemishes.”

    In the U.S. we are still struggling with enormous problems in healthcare. Ours is the only advanced nation that does not have some form of universal, “single-payer” healthcare for all citizens.

    In a capitalist country the term “single-payer” means that healthcare services may still be delivered by privately-owned hospitals, clinics, doctor practices, laboratories, etc., but that all citizens have on-demand healthcare backed up be a government insurance agency. All medical bills are paid by this agency at a standard fee for any particular service.

    This works well, but we in the U.S. can’t obtain such a system through the legislative process because too many of our legislators are bought off by the massive health insurance corporations.

    The political Left continues to rely on the legislative process however, instead of making a movement to alter the Constitution through a mass HRA (Healthcare Rights Amendment) movement.

    Perhaps the progressive-minded people will wake up someday and realize that the Democratic Party will never achieve single-payer through the legislative process, and shift over to a mass, Constitutional HRA movement.

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