Cuba’s Health Resources Dilemma

Fernando Ravsberg*

Havana's Calixto Garcia Hospital

HAVANA TIMES, April 29 – The Cuban government seems concerned. Vice-president Jose Ramón Machado Ventura has called on people to “foment a culture of rationality” in the public health care system and to “efficiently use the human resources and materials it possesses.”

For me this is an emotional issue, because I can’t help but to feel gratitude.  This must be a reflection of all those years when I would run desperately to hospitals with my kids in my arms; once arriving at one of these centers, I always found assistance, understanding and professionalism.

Anyone who believes that Cuban physicians provide such attention under obligation doesn’t know them.  I don’t deny that they might take advantage of their trips abroad to buy a TV or a stove, but to reduce their solidarity to mere economic interest is to commit an enormous injustice.

Lately, however, I’ve confronted a contradictory feeling.  I can no longer speak of the public health system as all-embracing.  The reality is that while some doctors work day and night in Havana, Guantanamo or Haiti, others do in fact squander their material resources.

The national media, however, blanket us with data on the Operation Milagro (eye surgery) program, the Latin American School of Medicine in Havana, the medical brigade in Haiti and other public health campaigns in Venezuela, Nicaragua, Bolivia and Ecuador.

Nonetheless, the first priority of the public health care system should be attending to the needs of Cuban citizens.  For this reason, Granma (the official newspaper of the Party) affirms that free public medical care is “one of the most valuable conquests in the Revolution.”

Despite this, administrative inefficiency is present in many of the of the country’s health care facilities.  The food and blankets of sick people are stolen, incompetent individuals are sent to purchase worthless equipment and fortunes are spent on construction projects that are useless.

In the warehouses of the ophthalmology center “they accumulate expensive equipment that we won’t ever use and that we don’t even know who ordered,” an older doctor in that specialty told me.  “Hundreds of thousands of dollars can be thrown away by one incompetent individual,” he added.

I couldn’t help feeling anything but shock when I found out that the burn unit of the Calixto Garcia Hospital has never functioned —not even for one day— “though it was inaugurated years ago by the highest-level political authorities in the country,” another doctor commented to me.

He went on to inform me that though its roof has caved in on several occasions, the Public Health Ministry pays again so that they repeat the same botched work. The State bought extraordinarily expensive bathtubs for burn victims, but they couldn’t be used due to the low water pressure.

Though there exists total chaos, no one wants to talk about it. “This is a mess,” a male nurse told me, while a doctor ducked away immediately after I had barely raised the issue. Notwithstanding, the built up rage could not be held in, and I was finally able to speak with some of them frankly.

I’ve been told that the State has allocated a large sum of money to build a new operating room in that hospital.  First rate materials are used at staggering costs.  “Everything in the bathrooms is name brand,” commented one employee.

Yet what everyone knows never becomes public.  Despite those enormous expenditures, the roof still leaks when it rains, water pressure tests revealed dozens of leaks in the pipes and it was necessary to break open the walls to open the windows.

The health ministry is applying pressure on hospital authorities to approve the work done, though they continue to refuse.  Administrators know from experience that to accept this would imply having another ward “inaugurated” solely for the television journalist, the same as with the burn unit.

What’s curious is that the Ministry of Public Health should be the first institution interested in rejecting this slapdash work.  Nevertheless, tiles continue falling off of the walls with no one wondering if someone might be stealing the cement.

This is the same cement that was used to repair and expand many homes in the Centro Havana neighborhood; it was the same cement that was diverted from work projects at Almejeiras Hospital, along with trucks of sand, rebar, wall tile, floor tile and anything else that could be sold.

While some hospitals “sell” construction supplies, at the Julio Trigo Teaching Hospital we saw how those people accompanying the sick were wandering the corridors with recipients full of fecal waste looking for somewhere to dispose this because the bathrooms were broken.

In the meantime, the Ministry of Public Health has just created the “Program for Efficiency and the Rational Use of Resources” and even a “Compendium of Economic Education for Leaders and Workers.”  Now it’s only necessary that they put these into practice.

An authorized translation by Havana Times (from the Spanish original) published by BBC Mundo.

4 thoughts on “Cuba’s Health Resources Dilemma

  • OK, yes there are problems. But something that needs to be said is that Cubans are hyper critical. Self-critique is revolutionary, and some things in Cuba, all things considered, really do run well. Your standards of waste and corruption are very high. There is much more waste and corruption in most other countries.

    While I want to see the revolution continue to evolve as well, we should stop and smell the roses of the revolution once in a while.

  • @grok
    You make sense in this post, I should really read the all other comments in succession.

    Anyway, should leaders actually hand out information, people will still have doubts. All politicians lie and people know it. Most just want to believe in their words for comfort and live on with their lives hoping things get better. It still baffles me why minorities in America vote for Republicans. Republican “patriotic” Presidents can make a fine show, but it takes a Democrat to fix the problem. Woo! Third derailment tonight!

  • The specific problem above represents what is always the same problem in general: that the ‘socialist’ bureaucracy in all spheres is not accountable 2 the people it serves; 2 the people serving in it; or 2 the wider society. & when some people finally blow the whistle on corruption, inefficiency or stupidity, etc. — this same bureaucracy also gets away with pursuing these heroes aggressively, in order 2 shut them up: another crime which usually goes unpunished.

    All leadership (@ least) positions in all institutions must B elected 1s in any democratic socialist society — voted 4 by the entire staff of these institutions — & subject 2 *immediate* recall, if necessary. Committees with the power 2 control resources must all be elected, & with full transparency guaranteed at all levels. Everyone must know what is going on in general, if not in detail.

    This change won’t guarantee everything, of course — but it will certainly guarantee a whole lot more than it does now.

  • The failure we see is a systemic failure of a top down approach.
    Those who have the power have no knowledge and those who have the knowledge do not have the power!

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