Before or after you see Michael Moore's "SiCKO," you must read the following testimony from a doctor well familiar with the Cuban health care system. (To read it in the original Spanish, go here.)
By Dr. Darsi Ferrer, via Misceláneas de Cuba:
Havana, June 30, 2007. The achievements of the Cuban Health System reflect the reality of the services offered in the centers and installations devoted to medical attention for foreigners and the members of the ruling cupola, which the total opposite of the dismal quality, insufficiencies and total deterioration of the services available to the general public.
Although it is not officially recognized, the family doctor and nurse program disappears in actual practice. So far the authorities do not implement any alternative to compensate as substitution for that plan, that was in Cuba BC the cornerstone of the primary health service and care.
In the latter years the “plundering” of physicians for the population reaches a figure higher than twenty thousands, to which we have to add tons of resources such as equipment, medications, suppliers and chemicals requisitioned to cover missions of political interest in the countries of Latin America and Africa.
In our country the majority of medical offices are closed for lack of staff. Physicians are forced to work 3 or 4 cities of more than one hundred and twenty families each for a salary of 22 dollars per month which does not cover even their bare necessities. Many offices stay open due to the work performed by medical students attending third year or later at medical school who obviously lack professional qualification and responsibility.
Hospitals and policlinics where the Cuban Joe Doke is treated are in bad shape due to building problems, lack hygiene and minimal conditions to offer adequate medical services. When the patients are admitted they must provide their own meals, utensils and supplies, such as sheets, towels, pajamas, fans, china, table service, glasses, light bulbs, medication, chemicals et al, among other difficulties they face.
Contrary to the orientation of multilateral organizations, the Cuban system is ruled by a centralization policy. The functioning of the system is planned at high levels of the government and forbids independent participation of the civil society in decision making and utilization of resources. This provokes a high level of bureaucracy, deficiencies, dysfunctional operations, ignorance of reality and corruption at all levels. Besides, it generates the use of lies as an official mechanism to “meet the goals” set by the “higher ups."
Even though the country centers with cutting edge technology where drugs are produced and even exported, the pharmacies lack all kinds of products. The deficit extends to even the essential medications such as analgesics, antacid, vitamins and minerals, syringes and thermometers.
An old lady known as Fina was admitted to the Julio Trigo Hospital suspected of having lung cancer. But it was not possible to perform a bronchoscope to confirm the diagnosis because the equipment was out of order. Coincidentally, a few days after admission she suffered a brain infarct which complicated her condition.
Octavio Armenteros had fever during several days that was associated with loss of appetite, difficulty in swallowing, shortness of breath, cold symptoms and progressive loss of weight. He was admitted in the 10 de October Hospital. The deplorable conditions of the facility made him go home. A “Godfather” of the family (a high ranking official) could get him admitted to Almeijeiras Hospital (reserved for the cupola and foreigners). There they diagnosed him with pulmonary emphysema, brochiectasis and a larynges tumor. He has been in his house for months in a desperate condition because he has no way of obtaining a simple oxygen bottle to mitigate his respiratory condition. Neither can him obtain follow up for the treatment of his tumor, with a clinical deterioration ensuing from all this.
It took almost a year for Lidia to, finally, obtain that a gastroscopy would be performed. The diagnosis was chronic duodenitis and peptic ulcer. The specialist a treatment and due to lack of physicians in the offices of her neighborhood , months have gone by and she can not obtain a certificate about the medications required so that the pharmacy that belongs her “health area” could sell them to her.
The increase in transmissible diseases has given rise to an ever increasing state if worry. During all year we see epidemics of dengue, hepatitis, leptospirosis, meningo encephalitis, respiratory and diarrheic diseases. Most of the population is affected by parasites, anemia and mal nutrition. Pathologies such as tuberculosis have high rate of occurrences and prevalence that are alarming.
Some programs that had achieved a degree of functioning within the system were abandoned several years ago. One that is a thing of the past is “massive mammograms”. This has made frequent that the diagnosis of breast cancer, highly elevated now and with tendency to increase, is made in advanced stages of the cancer when the possibilities of surgical treatment that could cure it are minimum. Also, in detriment of the women’s health, there are serious difficulties to carry out massive cytological tests, which generates an increase in deaths due to cervical cancer.
Given the case that no active checkups are made for the detection of cases of high blood pressure and diabetes mellitus, among others, many times the patients go to the doctor only when serious complications appear, factor that explains the increase in the vascular/encephalic accidents, cardiovascular problems, kidney insufficiency and other chronic illnesses that arise from this.
Similar situation is faced with those affected by HIV. Lately the number of cases diagnosed in the SIDA phase, that is, the full bloom stage of the disease with all symptoms and signs, which demonstrates the under recording of the data with a high percentage of patients without diagnosis and the lack of control in the national program carried out in the country.
The infant mortality rate (less than a year old) is one of the few programs that is still functioning, as it is an strategic indicator that produces political benefits at the international level when it is related to the development of human development and quality of life among other aspects. Of course, it is not explained to the public that in Cuba this low infant mortality rate is associated with astronomical figures of abortions. The doctors are supposed to suggest abortion in risky pregnancies y, in some occasions, must perform the interruption without the consent of the couple.
It is probable that as long as the apartheid in medical services continue and, therefore, the people is negated access to medical assistance in “differentiated hospitals” such as Cira Garcia, CIMEQ, Frank Pais, La Pradera, Almeijeiras, Koly and other, exclusively devoted to foreginers and members of the “high ruling class”, the Cubans keep resisting the use of the health system and opt for “santeria” (witch doctors) and herbal treatment with the prevalence of generalized inconformity with the poor quality of the medical services.
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