Waiting in Line for Cuba’s Healthcare Services

By Pilar Montes

HAVANA TIMES — Most visitors to the island marvel or are astonished at how often Cubans head down to the doctor’s office, polyclinic or hospital, even when they’re in good health.

What they don’t know is that this is the only way Cubans can get the prescriptions they need, renew their treatment plans or get doctors to write up prescriptions for dipyrone or aspirin, simple analgesics that can only be obtained at the pharmacy with a doctor’s note.

There are also a lot of hypochondriacs that accumulate all kinds of prescriptions “in case they need them.” Those who go to pharmacies to buy the medications they need now or could need in the future are therefore in the thousands, perhaps even the millions.

Clinics are also where people get referrals to see specialists at polyclinics, a dietary plan which increases their food rations, medical certificates for work or notes to get simple blood pressure and sugar checkups, as these lack the basic instruments needed to conduct these tests quickly.

Low-income elderly people often hope the doctor will diagnose them with a condition that will entitle them to a special dietary plan.

In one of the very rare articles dealing with the issue, a Granma journalist described the problems surrounding the long lines of people outside clinics thusly: “Some are caused by excessive red tape, others by lack of competition. What’s certain is that growing lines of people are a sign alerting us to the poor quality of a service and an evident lack of interest in trying to change or improve things.”

“We all know that those who work with the public must have an extra quota of patience and charisma. If the mentality of working less because of low salaries or lack of motivation at the workplace prevails, we will continue down the road of cutting corners and accumulating unresolved problems.”

Even if you’re the first in line, the disabled, pregnant women and those who have come for a post-op checkup are let in ahead of everyone else. Then, those in line are seen in order of arrival.

At these clinics and hospitals, where one can leave without a diagnosis because the needed tests cannot be conducted for any number of reasons, people hold long conversations, and loquacious patients can tell you about their current ailments, those of their kids and relatives and the illnesses they could suffer in the future.

Once these items of the agenda have been addressed, that person can turn to a neighbor and subject them to a third-degree not unlike those seen in cop shows. Once they have satisfied their curiosity, they will offer their verdict, favoring this or that diagnosis with the utmost certainty.

This way, the country’s economy is hit by the absence of these individuals from work, and the absentees will either feel reassured in their worries or anxieties or, on the contrary, fall deeper into their depression as a result of their conversation with the other patient.

Another source of frustration and stress is being told the clinic ran out of X-ray plaques or the machine is broken, or similar news about the ultrasound and echocardiograms. This entails coming back or calling several times in advance to find out whether these tests are being conducted.

I am not blaming the health system, lacking in medications or spare pieces for diagnostic instruments because of the US blockade, but the indolence of technicians and professionals in view of the patient’s problems and pains is truly bothersome. These professionals could well inform the clinics near the patients’ homes of these issues to spare them long trips and lines.

Pharmacies

The despair experienced by people standing in line to buy medications at a pharmacy is a common sight. The number of people waiting to buy their medication seems to grow and grow, despite the fact there’s no shortage of pharmacists behind the counter.

An hour goes by and one is still standing there, waiting. Some fall prey to anxiety when they hear a gentleman say one of the saddest things about this whole issue: “We’ve grown used to standing in line and they’ve grown used to making us wait.”

Speaking of pharmacies, I try to buy my medication on Sundays, when there are less people and only one clerk. Chronic patients and people with diabetes, hypertension, allergies, asthma, circulatory and other conditions buy their medication using a card commonly referred to as “the big card”, a document meant to resist all weathers and the wear and tear caused by their constant use.

At these lines of people, made up mostly of the elderly, there is no shortage of medical and pharmaceutical experts (who studied neither discipline). Anyone there can suggest or warn of a specific treatment prescribed by the doctor.

These “self-taught experts” recommend all manner of herbs and roots and even the benefits of occult science, seers and prophets, who tell us who cast the evil eye on us or want to distance us from our loved ones. There’s also those who tell us a relative or acquaintance died of the same condition one has under the treatment prescribed to us.

The next post on this subject of lines will address the situation of urban and inter-provincial transportation and the different lines of people that surround them for travel by land, sea or up in the air.
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See Part 1 of this series on lines in Cuba.