HAVANA.- When in Cuba is paid in Dollars the difference is remarkable. If you are a foreigner and visit the Luis de la Puente Uceda minimal access surgery hospital, on Párraga street between Vista Alegre and San Mariano, in the populous neighborhood of La Víbora, twenty minutes by car from downtown Havana, you will receive careful attention.
A cleaning assistant pours a stream of air freshener onto the immaculate floor of the clinic, where there is no shortage of blankets and no shortage of water. The nurses are affable and the doctors always smile. The toilets call you sir or ma’am. In the admission rooms they prepare a different menu for lunch and dinner.
The custodians, with grim faces, clear the way for ‘unauthorized personnel’. To a clueless mother who went in to give her daughter a spray, the guard says: “Comrade, this place is now for foreigners. The guardhouse from when it was a polyclinic was relocated several blocks away.”
An official proudly points out that “this minimal access surgery hospital is the best of its kind in Cuba and probably one of the best in Latin America.” And she clarifies that “people come from many parts of the world to be treated here.”
In order to cover the demand, the six floors of the old Luis de la Puente Uceda polyclinic-hospital, which served residents in different areas of the Diez de Octubre municipality, were no longer enough. A room dedicated to the rehabilitation of patients was built in an old parking lot.
Yosmani, a neighbor on the block, explains that “in that space it was planned to build a building for families that had lost their homes due to the passage of the cyclone. But the priority is to earn dollars” The need to expand the hospital also affected a daycare center that was in poor condition. “But one day state brigades arrived and in three or four months they remodeled it,” says Magda, another neighbor.
The former children’s circle was converted into an admission room with air-conditioned rooms, flat screen televisions and bathrooms with hot and cold water. An extra floor and security cameras were added in the surroundings.
“Then the government fills its mouth to talk regarding equality and socialism. Many mothers with small children, like me, were affected. They sent us to a circle in Santa Catalina and Buenaventura, which closed due to damage to its structure and problems with the water supply. When it comes to clinics dedicated to tourism, money appears, but when it comes to the town, screw them,” says Daniela, a housewife.
Six blocks from the minimal access surgery hospital, in a dilapidated house, the guardhouse of the old polyclinic-hospital was relocated, which before 1959 was a private clinic and following it was nationalized and renamed following the Peruvian guerrilla Luis de la Puente Uceda, at least until the 1980-90s, was one of the best public health centers in Havana.
At present, neglect and deterioration are evident. In the absence of blankets, an employee cleans the floor with an old sweater. Nobody is called ‘sir or ma’am’, if not ‘partner and partner’. The generation plant does not work if there are blackouts. And patients have to carry the mouthpiece to give themselves an aerosol and disposable syringes to inject themselves. Today it is part of real Cuban socialism.
In the ‘people’s’ hospitals, the specialists have a consultation once a month, when they attend. If you want to receive good care you will have to give them gifts. It might be a lunch, a phone recharge card or a five dollar bill. Then, by magic, missing drugs appear, although you can’t always guarantee optimal treatment. Braulio, a retiree, paid ten dollars and was able to get an appointment with a dermatologist, “but then I mightn’t get the prescription drugs.”
A doctor confesses that there is a range of treatments, depending on the purchasing power of the patient. “Those who come for the ‘book’ (that’s what they call those who don’t give gifts), are prescribed what is in the pharmacy, which is practically nothing, or medicine green that takes months to heal. Those who have foreign currency are given the link of WhatsApp or Telegram groups that sell medicines brought from abroad or the address of the international pharmacy that sells them.”
In the informal market, a 500-gram bottle of vitamins C brought from Miami costs between one thousand and one thousand five hundred pesos. A first-generation antibiotic can be around four thousand pesos for the complete treatment and an asthma spray, more than two hundred pesos.
The pharmacy located on Calzada Diez de Octubre between Patrocinio and O’Farrill, in La Víbora, is the main one in the municipality. An employee indicates that “drugs considered basic should not be lacking. But it’s been more than twenty days since no one has entered. We have a shortage of more than 700 medications. There is no dipyrone, there are also no ointments, syrups, antibiotics. Not even distilled water. And for two months there have been no drugs to control diabetes and high blood pressure”.
This was recognized by Rita María García Almaguer, director of operations and technology of the pharmaceutical industry (BioCubaFarma), to the official press. “From 2016 to date we have had a very difficult period to guarantee the supply of 801 medicines in the Basic Table. 505 of which are produced in the country and the rest imported mainly from China, India and European countries.
García Almaguer attributed these problems to the fact that “more than 85% of the resources we use in the production of medicines are imported. The lack of timely financing to pay the suppliers with whom we have negotiations to acquire raw materials, containers and supplies resulted in the lack and low coverage of certain medicines in the country”.
By 2022, the health authorities promised increased drug production. “Certain levels of antibiotics, diuretics and hypertension drugs are being produced and salbutamol spray is being imported from India. But the demand far exceeds the supply,” says the shift manager of a drug manufacturing plant west of the capital.
While in the exclusive clinic located in La Víbora they have state-of-the-art technology, in the island’s public hospitals conditions are precarious. Missing from syringes to cotton. “We don’t even have gloves. I always ask patients to bring disposable syringes, as the sterilization equipment does not meet the appropriate parameters”, points out a nurse.
The same thing happens in dental clinics. Sara, a dentist, has not worked for ten days due to “lack of anesthesia and other supplies, not to mention that the water in the cistern is contaminated and no one has come to solve the problem.”
Added to the shortcomings and difficulties, rampant corruption in health institutions causes donation medicines to be stolen and resold in the informal market or doctors use them on patients who pay or give gifts.
Oneida has her mother admitted to La Dependiente, one of the main hospitals in the Diez de Octubre municipality. She states that “in the admission rooms, cleanliness is conspicuous by its absence. The bathrooms are disgusting. In addition to bringing sheets, fans, towels and pajamas, among other items, we have to bring cotton, disposable syringes and medicines. And enough money to buy food and snacks for the nurses and doctors. It’s the only way to get good care. It has been a while since public health in Cuba stopped being free.”
Castroism has designed an outlandish country. In 2021, the regime invested 57 times more in tourism than in public health. In the economic belt around the port of Mariel, just over 40 kilometers west of Havana, a brand new biotechnological center was inaugurated a year ago to produce sophisticated medicines and vaccines once morest the pandemic, but it is incapable of producing a simple aspirin.
For a year and a half, Laura, a retired teacher, has been waiting to have a breast cyst operated on. “The doctor tells me that surgical interventions are stopped due to lack of resources. They only prioritize urgent ones.” When the patient has dollars the story is different. Thanks to relatives abroad, Yulia, a designer, had cosmetic surgery on her abdomen and waist for $1,400. “The specialist who treated me had all the resources. They performed the intervention at Calixto García, which is a state hospital.”
And it is that the green ticket of the ‘enemy’ guarantees certain privileges in Cuba.
