It might be world renowned but I’m still not sure I’d want to get ill….

In a diversion from today’s planned ramble I wanted to take a quick detour to talk about one of (two of) Cuba’s famous victories of the Cuban revolution: the health service. 

I feel somewhat inspired to do so after spending the afternoon in hospital. Just to confirm it wasn’t me that was being seen and neither thankfully/hopefully are either of the concerns serious ones. However, since I got to spend 4 hours waiting in a paediatric hospital and another couple in a gynaecological one, I feel moderately qualified to write on this experience, with the help of some information taken from some books I have here.

Just as famous as its reputation for bad food, good cigars and energetic ballet is Cuba’s magnificent record for healthcare. Once upon a time Castro had a dream that the country would become “the greatest medical power in the world”. He might not have been able to make the economy work but he sure did get somewhere with healthcare. Today Cuba’s welfare state is the envy of many countries in the developed world, let along the so called third one.

The state spends about 12% of its budget on healthcare – serving the people directly and training up doctor’s enmass: 70,000 to date in 20 medical schools worldwide (The whole of the African content has only 50,000). That’s about one doctor for every 170 residents. Plenty to keep on top of health in Cuba - immunization is currently 100%, every community has a family doctor and every town a hospital, and the life expectancy is 78.3 years – just behind only Chile, Costa Rica and Puerto Rica in Latin America and ahead of (you guessed it), the USA. The country also boasts state of the art technology, world leading research centres and is particularly famous for its treatment of patients with Parkinson’s disease and those needing eye operations.

But there is also enough to give them wings and send them to health-poor countries in the global south. Cuba’s willingness to share such progress puts many developed countries to shame; it currently has on-going medical programmes with 58 developed countries in the global south. 

This I knew before my visits and it had built my expectations up high. However under resourced the schools, shops and small businesses were I was sure that the hospitals would be the exception. Nope. I was quite shocked. 

Firstly, they were both hastily constructed and poorly maintained buildings run without air conditioning or functioning lifts – at least the lifts didn’t work when we were there. Isis friend who we visited is heavily pregnant but needs to be in hospital for the remaining 6 weeks because of possible complications. She shares a room with one other lady, two stationary fans, one bed side table and an army style mattress and pillow. There is one tele in the corridor, though it’s hard to tell exactly how this is used. Some people had brought in laptops but only since 2008 have people been able to own them so they’re not yet within everyone’s reach.  She was not complaining at all though. Indeed her only distress was that her 8 year old son was only able to visit on Sundays and even then he couldn’t come up to the 4^th floor to see her; she needed to be taken down on the mechanical chair because she isn’t allowed to be moving around. The one problem: the chair is out of order.

The situation in the paediatric hospital was similarly eye opening. Isis was meant to be seeing a consultant about some tests they did on Miguel Eduardo (her 5 year old). The consulting hours were 1 till 3, more or less. We arrived at 2 and the doctor had gone into surgery. There was no way of telling how long he would be but because he only sees people on a Tuesday, and there doesn’t seem to be an alternative phone/email/internet service to get hold of him, there was nothing to do but wait. Fortunately we both had some reading to do, but I was rather distracted by the kids being wheeled out of surgery on what looked like converted shopping trolleys without any electrical equipment hooked up to them and minimal bandaging. This was no ER. After 4 hours I went to look for some food in the ‘cafeteria’ – but it was empty and there was none. When our consultant (a tall, skinny man with a funny sense of humour – dad?) came out of surgery he saw us straight away.

Some of this concurs with the more painful side of healthcare here and outside Havana many reports are far worse. As in many other areas, resources are being shifted so that foreigners can be prioritised above national citizens in their own country. This is being reported particularly in surgical and advanced medicine fields. It’s also tough luck if you’re a Cuban needing pharmaceuticals. The country makes them but, de-ja-vous, they’re exported to earn some cash, and Castro refuses to permit imports for his people. I’m talking everything from Omega 3 capsules to life saving cancer drugs. Castro even rejected a large package of medical assistance from the USA in 1999 that was desperately needed.

Partly because of the unreliable nature of pharmeceuticals, partly because of a strong culture of inter-generational knowledge transfer, Cuban people are very into their medicinal plants. There is a section of the Organopónico dedicated to selling shoots, fruits, leaves and roots to numerous customers that arrive each day. When Ramón (an elderly gentlemen who plies me with fresh coconut water at every opportunity) was kind enough to show me some of what the allotment had to offer, I found the quantity, quality and promise of these plants fascinating. Some are specific to the Caribbean, some we know and use also (Aloe Vera and Mint are I’m ashamed to say the only two I recognised), and those I’d never seen I’m hoping to discover some more about - another culture that sprung up out of necessity has planted some very intriguing roots. 

Though glad to have been able to see the doctor this time Isis left the consultation weary and troubled. Her son needs an operation which, though small, requires a general anaesthetic – which obviously always carries an element of risk. Neither can she be sure when they’ll be able to operate. Next week marks the beginning of the summer holidays and getting anything done in the next two months is apparently 99% impossible. Though most people cannot and do not take themselves off to a beach resort somewhere it’s very difficult to pin people down, and with her studies at the university, job and family to think about, it’s another trial she needs to grin and bear.