Medical Matters in Cuba
February 13th, 2012 | Blog, Cuba, Musings/Reminiscences | 3 Comments
In the comments section to my 1/31/2012 Cuba post, Emily’s asked whether we were involved in the actual delivery of the medical supplies we took over and what free medical care means in Cuba. I can answer the former but not the latter question.
Those of us on the tour carried over-the-counter medical supplies of a wide variety, since pretty much everything you could buy at a Walgreen’s or CVS are needed. We were encouraged to spend about $50.00 each, as I recall. We had both a “drop” in Santiago and in Havana. In Santiago we met with two nuns at our hotel who collected half our donations, and in Havana we visited a St. Vincent de Paul nursing home for women, where we gave the nuns the rest of our goods and toured the home. It was extremely clean, peaceful, and pleasant, despite the age of the buildings. It was run, of course, by the Catholic Church, and not the government, so it wasn’t typical. We were told the nuns had something like a central clearing house for the medical supplies. Ours would be distributed where they were most needed across the country, not just at that particular nursing home.
We spent a good hour at the nursing home, which was about 45 minutes too long for me. I speak as someone who spent seven years of her life visiting her mother almost daily in a nursing home, so my interest in nursing homes is pretty much depleted. There were two beds to a room, neatly made and in perfect order, some with teddy bears or private refrigerators brought from home.
The residents were calm and old (surprise), though some were younger with Down’s Syndrome. We looked into every possible nook and cranny– the kitchen, the dentist office, the infirmary—taking endless time because our Cuban guide was obviously proud of the facility, as well as wanting us to honor the nuns and residents with our attention.
I, on the other hand, was chomping at the bits to get going to the next thing on the schedule: a walking tour of Old Havana. I thought of that Faulkner line about how if a writer has to rob his mother, he will not hesitate. “The ‘Ode to a Grecian Urn’ is worth any number of old ladies…’” Well, to me, getting to walk around historic old Havana was worth any number of old ladies. I could tell our long visit to the nursing home would cut short the walking tour, which it did. I am a Bad Person. (I also realize if I make it that far I’ll be one of those old ladies….)
As for what free medical care means in Cuba, I have no idea. A quick Google search of the topic revealed that you can choose just about any opinion you want, from high praise to critical condemnation. Obviously the facilities are rundown, there is a problem with equipment and essential drugs, and yet life expectancy and infant mortality rates in Cuba are nearly equal to the U.S. Our Cuban guide, who worked for the government, but who seemed a straight shooter within the confines of her official role, spoke positively about the fact that medical care is free. There are waits and delays, such as when the operating room is not operational, one certainly doesn’t have choice of doctors or care, and it’s hard to imagine that the hospitals can meet our standards of sanitation. But it is free for everyone, across the board, for everything.
I mused on this because shortly before leaving for Cuba, I was recovering from a cold and my ears were stopped up, as if I were underwater. I went to the walk-in clinic in Key West a day or two before I was to fly, and was promptly seen by a baby nurse practitioner who wrote me out three prescriptions—for an antibiotic, prednisone, and Flonase—things I would never be able to pry out of my internist back in Minnesota over a cold (and none of which I had to use). Off I went, feeling cured and well-cared for. Only I did ask as I breezed out the door how much it was going to cost. Self-insured, I have an astronomically high deductible. I knew that eventually I’d be paying. They didn’t know for sure, but “over a hundred dollars…” Plus the prescriptions. It was quick, efficient and costly. In Cuba it would be slow, inefficient and free. I know there are people in Key West, those working in the restaurants and bed-and-breakfasts, who cannot afford insurance or go to a doctor except in an emergency and then it’s a financial crisis. We may have some of the best medical care in the world in the U.S., but only for those who can afford it.
Cuba exports doctors to Venezuela, in exchange for subsidized oil. Doctors in Cuba make very little money, so perhaps they’re able to send money back to Cuba from Venezuela. It takes five years of higher education to become a doctor in Cuba. Since money is not the incentive, the desire to help may be the motivation. We learned that Cuban medical researchers are developing vaccines for diseases that ravage the poor in developing countries, such as whooping cough, cholera, malaria, and dengue fever. Europeans, Latin Americans, Canadians come to Cuba for eye surgery and all kinds of medical care–medical tourism.
We had one small medical emergency on our tour, though of course to the person to whom it happened, it was not small. Jill, one of the women traveling alone, and whom I liked in particular, fell on the sidewalk near our hotel. The sidewalks and streets are uneven and the many columns have base supports that you don’t see if you aren’t watching carefully. Up until her fall, Jill and I had had a little running thing in which at various moments we’d say, “Aren’t we happy!” She is a joyful person with a radiant smile, and she was having a great time in Cuba. One morning we went from the bright, tropical sunlight into a dark house where we were going to have one of the religions, Santeria, explained to us. In the dark living room, there was a statue of a small black person seated in a chair, about the size of a child. Jill, her eyes not yet adjusted to the dark interior, thought a real person was sitting there, and greeted it before realizing it was a statue. When she told this story on herself, we laughed our asses off.
Jill and her roommate were hurrying to the Floridita Bar, Hemingway’s bar,
just a block or two from our hotel, when she went around a column one way and her friend the other. Jill went down hard on hard pavement. She didn’t even know how it happened it was so fast. Three Cuban men rushed to her aid, and one ran her back to the hotel, with Jill holding a cut over her eye that was bleeding profusely. The nurse on duty at the hotel tended her. Jill had had a knee replacement, and was worried that she had wrecked that, she had a swollen wrist, and had bruised her shoulder and side. A day later a doctor came to the hotel to see about her, and recommended she go to a clinic. But Jill didn’t want to. I would have gone, I think, just to see what it was like. But she soldiered on and continued to partake of the tour, though after that we didn’t say to each other how happy we were. Instead I gave her Tylenol. She was in pain.
I wish I had a better sense of what it is like to live in Cuba, and what medical care is like there.
I suspect that the people, like Jill, soldier on.