Medical Matters in Cuba
February 13th, 2012 | Blog, Cuba, Musings/Reminiscences | 3 Comments
Compiling the OTC medical supplies we took to Cuba
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.
Our visit to the St. Vincent DePaul nursing home in Havana
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.
Pleasant, clean, orderly rooms
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.
Buenos dias! oops...
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,
Hemingway's favorite bar in Havana
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.
Thanks for talking about this subject, Paulette. I remember a colleague comparing free medical care in Communist countries years ago to our pricey American variety. I was fresh from a trip to the Far East and, when she mentioned China I said, But they don't have any medical care in China.
By our standards, that was sort of true then, though it ignored traditional medicine and the simpler forms of medical intervention. We're used to dramatic medicine–scans to identify the source of pains, transplants, chemotherapy drugs that are $10,000 a pop. Medical systems vary widely and wildly around the world and even in the US where what we receive in the way of treatment depends on insurance and access.
Personally, I admire a society that makes the best medical care it has available to everyone. I like it that that's a priority in Cuba. It's also interesting that there are humanitarian ventures that are maybe analagous to food pantries and drives. There has to be story material in stocking up on Band-aids and alcohol swabs at CVS.
In 1993, the Duluth News-Tribune sent me to Cuba to cover an exploratory sister-city mission. The sister city relationship, between Duluth and Pinar del Rio, never materialized. But the expedition was fascinating. It was a medical mission, too, and I tagged along as four or five Duluth doctors toured neighborhood clinics and interviewed medical staff.____At that time (and perhaps still), clinics were in the center of neighborhoods, and if you lived in the neighborhood, that was your clinic. If you moved, they gave you a cardboard box of your medical records, which you brought to the clinic in your new neighborhood.____The doctors were also very low on supplies–this was shortly after the collapse of the Soviet Union, which had been Cuba's main trade benefactor, and they were low on medicines and even soap. Most clinics I visited had little gardens out back where the doctors grew medicinal herbs.____But everything was very clean (though spartan) and at that time (and perhaps still) Cuba had a much lower infant mortality rate than the US.__It was a fascinating trip.
Laurie, that's a really interesting look at what the Cuban medical system was on the ground nearly twenty years ago. I wonder if it's changed much since. If Paulette's group was still asked to take the most basic supplies, probably not. It's particularly intriguing about the medical herbs. And at a time when the U. S. Is pushing to computerize all files to cut down on medical errors, the idea of transporting personal records in a cardboard box makes quite a contrast. I wonder how various medical statistics stack up now between the two countries. My guess is that neighborhood medicine puts a thumb on the scale in favor of good health.