Free Health Care in Cuba?

Moses Patterson

HAVANA TIMES — A much heralded triumph of the Cuban revolution is the “free health care system”. Cuban propagandists will even favorably compare the Cuban system to US health care delivery.

I imagine, few, if any, of these apologists, have ever experienced either one, let alone both systems. I just spent last week experiencing the Cuban health care system. Let me explain:

My wife and I travelled to Cuba last week to help my mother-in-law recover from surgery. She was going to have to spend at least three days in the hospital post-op and several more days motionless in bed at home.

We arranged to rent a large ‘casa particular’ or rental apartment close to the hospital with two bedrooms and two bathrooms so that my wife and I could be comfortable and attend to her mother.

My wife’s family is from Guantanamo, but the surgical hospital in Guantanamo, which was damaged by hurricane Sandy last year did not have the surgical equipment available for the specific surgery my mother-in-law needed, so for a variety of reasons, we decided to have the surgery in Havana.

Prior to the trip, my wife wisely purchased towels and two sets of sheets and pillowcases for her mother’s use during her hospital stay. In addition, we packed several aerosol cans of spray disinfectant, special soap used for sponge baths and a room air-freshener that plugs into to an electrical outlet.

Although this Havana hospital provides linens, the quality and hygiene of the supplied linens is questionable. Needless to say, you don’t need to bring your own linens for US hospitals.

The morning we brought her to the hospital, it was hard to ignore the dimly lit halls inside and the faint smell of urine and disinfectant that seemed to be nearly everywhere. Even though I knew this was the best option available to us in Cuba, I could not help but think that if this was the US, there would be no way I would leave my mother-in-law in a hospital that smelled like this.

We were told the elevators weren’t working that day so we had to trek up to the fourth floor for the pre-operation prep and to speak with the surgeon.

It was clear to me that the staff in this hospital worked and moved about similar to the way hospital staffs move about in the US. Although there were some staff who seemed content to simply sit around and talk, there were others who kept busy doing their jobs.

My wife is still recognized on the street from her days as a national newscaster several years ago so it was hard to tell how much of our initial ‘special treatment’ was just because of her former status in Cuba and how much was standard customer service.

Still, it is fair to say we were well-received and everyone was polite and even pleasant. Under these working conditions, that is worth no small recognition.

After I completed my job carrying the small suitcase with the sheets and towels and personal items up the stairs, I decided to wander around the hospital a little while my wife and mother-in-law met with the surgeon.

It was clear to me that the staff in this hospital worked and moved about similar to the way hospital staffs move about in the US. Although there were some staff who seemed content to simply sit around and talk, there were others who kept busy doing their jobs.

It was raining outside so it was even more hot and humid inside than normal and if there was any air-conditioning it was fighting a losing battle. There were noisy fans on all the floors and pushcarts half-filled with soiled linens left in the halls.

The real difference was the hospital itself. There were more broken than unbroken windows. Even the unbroken ones still had the “X” tape-blocking from the last hurricane to threaten La Habana nearly five years ago. If the interior of the hospital had once had a color scheme, it was no longer evident.

Most of the walls needed a couple fresh coats of whatever color to hide the years of gurney crashes and greasy hands.  Floor tiles, mostly broken, were a hodge-podge of colors and markings as well.

Even the most conscientious janitor would have to go about their cleaning chores by memory because the structural deterioration as well as imbedded dirt and grime would never betray what was clean and what was not.

Despite these physical conditions, the two hour surgery thankfully went well. My wife, upon hearing the good news from the surgeon prompted me to slide a 100 cuc bill in his hand (Keep in mind that this ‘tip’ tripled his monthly salary).

We thanked him and asked if he would continue to visit ‘mi suegra’ and we would see to it that he was taken care of again before we took her home. He nodded his understanding. I still can’t imagine tipping a surgeon in the US.

We thanked the doctor and asked if he would continue to visit ‘mi suegra’ and we would see to it that he was taken care of again before we took her home. He nodded his understanding. I still can’t imagine tipping a surgeon in the US.

I then left for the store to buy juice for my mother-in-law, the Cuban equivalent of flowers in the US. When I returned to the hospital later, she was still in recovery. Since she was going to be groggy for the next few hours, my wife busied herself finding out who would be on staff that night.

She arranged that the bed was made up with the new sheets. Ten cuc to the shift ‘jefa’ assured that she would get the best mattress available and that her suitcase would be unmolested.

The next two days for me was spent shuttling food and juice to the hospital for my wife and her mother. I even brought back pizzas and soda for the staff. The spray disinfectant came in handy for the bathroom.

Her ‘room’ had ten beds and 8 men and women patients with no dividing curtains for privacy. Again, even the worst private and semi-private rooms that we take for granted in the US were simply not available in this hospital. Believe me, we asked.

We plugged in the air-freshener across the room and by the second day it began to have an effect. The other patients in the ward also brought sheets and towels and their own food. Fruits and juices were offered and shared by everyone.

The doctor managed to look in on my mother-in-law frequently. So did the nurses and even the staff responsible for cleaning. Word must have gotten out that my wife was a good tipper.

At the end of the third day, my mother-in-law had arranged to trade her used sheets and towels for a week’s supply of Vicodin and Percocet with another MD on staff.

These top-shelf painkillers are normally not available in Cuba. She had also arranged for one of the nurses who worked in the afternoons to drop by the rental house to check on her in the mornings on her way to work. (10 cuc per visit)

When we added up the costs of linens, juices, pizzas for the staff, tips for the doctors and nurses and other odds and ends, my mother-in-law’s three day hospital stay in La Habana costs my wife and I just less than $400.  If she had had the same procedure done in the US, her deductible would have been at least $1000.

As far as we know, she is no worse for the wear. Her surgeon and the staff seemed caring and attentive. I have no way of knowing how much of a difference was made because we had resources typically not available to the average Cuban.

We also do not know if the same service would have been better or worse in Mexico City, Guatemala City, or Buenos Aries. We do know now that hospital conditions are much better in the US. We also know that without ANY resources, her experience could have been worse. Much worse.  Cuban health care is at least adequate but it is certainly not free.