If you want to know the truth about Cuban healthcare, go the source, a real Cuban doctor, treating average Cuban citizens.
It’s not pretty, and the truth is very different from the theme park version dished up to Michael Moore.
Some of the ugly truths reported by the good doctor:
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 John Doe is treated are in bad shape due to building problems, lack of 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.
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, and meningo encephalitis, respiratory and diarrheic diseases. Most of the population is affected by parasites, anemia, and malnutrition. Pathologies such as tuberculosis have a high rate of occurrences and prevalence that are alarming.
The article in its entirety is below, in both English and Español, via Junta Patriotica Cubana.
H/T: Mayda
The following was written by Dr. Darsi Ferrer, an experienced Cuban physician who is very familiar with both the present, and the past Cuban health systems.
Dr. Darsi Ferrer, Director Center for Health and Human Rights ,“Juan Bruno Zayas”, Havana, June 30, 2007
The known 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 is 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 John Doe is treated are in bad shape due to building problems, lack of 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 thediagnosis 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 are denied 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 their generalized inconformity with quality medical services.
Miami, Florida.
July 3, 2007
For further information, please contact:
Junta Patriotica Cubana
Human Rights
Ph.: (305) 448-9898
Fax: (305) 567-9548
Email: jpcubana@bellsouth.net
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¨El Cuestionado Mito de los Avances del Sistema de Salud de Cuba¨.
Por el Dr. Darsi Ferrer, dir. Centro de Salud y Derechos Humanos ¨Juan
Bruno Zayas.
La Habana, 30 de Junio de 2007.
Los logros del sistema de salud cubano corresponden a la realidad de los servicios que se brindan en los centros e instalaciones destinadas a la atención médica de extranjeros y de los miembros de la cúpula del poder. Contrario a la pésima calidad, insuficiencias y franco deterioro de los servicios con que cuenta la población en general. Aunque no se reconoce oficialmente, el programa del médico y la enfermera de la familia en la práctica desaparece. Hasta ahora, las autoridades no implementan ninguna alternativa para compensar la sustitución de ese plan, otrora piedra angular del sistema de atención primaria de salud. En los últimos años, el despojo de médicos al pueblo alcanza una cifra superior a los veinte mil, con la suma de toneladas de recursos, entre equipos, medicamentos, insumos y quimicales, desviados para cubrir misiones de interés político por países de Latinoamérica y África.
En el territorio nacional la mayoría de los consultorios médicos están cerrados por falta de personal. A los galenos los obligan a trabajar con 3 o 4 poblaciones de más de ciento veinte familias cada una, por un salario de unos 22 dólares mensuales que no satisface siquiera las necesidades básicas. Muchas consultas se mantienen abiertas por la labor que prestan estudiantes de medicina que cursan el tercer año de la carrera en adelante, carentes de calificación y responsabilidad profesional.
Los hospitales y policlínicas donde se atienden los cubanos de a pie están en mal estado, con problemas constructivos, faltos de higiene y de condiciones mínimas para brindar servicios médicos adecuados. Los pacientes cuando ingresan deben proveerse su alimentación, enseres como ropas de cama, toallas, piyamas, ventiladores, cubeta, vasos, cubiertos, bombillas, incluso medicinas, reactivos, entre otras dificultades. A diferencia de las orientaciones de los organismos multilaterales (OMS, OPS), el sistema de salud cubano responde a una política de centralización, todo el funcionamiento se planifica por las altas instancias del estado y prohíbe la participación independiente de la sociedad civil en la toma de decisiones y la utilización de los recursos. Ello provoca un alto nivel de burocratismo, deficiencias, inoperancia, divorcio de la realidad y corrupción a todos los niveles. Además, engendra la implementación de la mentira como mecanismo oficial de cumplir con las metas establecidas desde ¨arriba¨.
Aunque el país cuenta con centros de tecnología de avanzada donde se producen y hasta exportan medicamentos, en las farmacias se carece de todo tipo de productos, el déficit alcanza medicinas esenciales, entre ellas, analgésicos, antiácidos, vitaminaminerales,
jeringuillas, termómetros, etc.
La anciana conocida por Fina ingresó en el hospital Julio Trigo de la Capital por sospecha de presentar Cáncer de Pulmón, no fue posible a los médicos realizarle la broncoscopía para confirmar el diagnóstico por estar roto el equipo. Casualmente a los días de su admisión en la sala sufrió un infarto cerebral que complicó su situación de salud. Octavio Armenteros tuvo fiebre elevada varios días que se le asociópérdida del apetito, dificultades con la deglución, falta de aire, síntomas catarrales y pérdida de peso progresiva. Lo ingresaron en el hospital 10 de Octubre, las deplorables condiciones de la instalación lo llevaron a irse enfermo para su casa. Un padrino de la familia (dirigente de alto rango) le resolvió ingreso en el hospital Almeijeiras, allá le diagnosticaron un enfisema pulmonar, bronquiectasia y tumor de laringe. Lleva meses en su casa desesperado por no tener acceso a un simple botellón de oxigeno que le ayude a paliar su limitación respiratoria. Tampoco consigue seguimiento para el tratamiento de su tumoración, en lo que se le deteriora el cuadro clínico. Pasó cerca de un año para que a Lidia le hicieran, al fin, una gastroscopía, el diagnóstico dio por resultado duodenitis crónica y ulcera péptica. El especialista le indicó tratamiento y por no haber médicos en los consultorios de su barriada, hace meses que no encuentra solución a la necesidad de tener un certificado de los medicamentos para que se los vendan en la farmacia del área de salud a la que pertenece.
El incremento de las enfermedades transmisibles es motivo de creciente preocupación. Todo el año azotan epidemias de dengue, hepatitis, leptospirosis, meningoencefalitis, brotes de enfermedades respiratorias y diarreicas. La mayoría de la población padece de
parasitismo, anemia, desnutrición. Patologías como la tuberculosis tienen una incidencia y prevalencia alarmantes.
Hace años se abandonaron programas que lograron algún funcionamiento dentro del sistema. Las mamografías masivas son cosa del pasado, en lo que se ha hecho frecuente que el diagnóstico de cáncer de mama, muy elevado y con tendencia a aumentar, generalmente se haga en estadíos tardíos de la enfermedad, cuando son mínimas las posibilidades de intervenciones quirúrgicas curativas. También en detrimento de la salud de las mujeres hay grandes dificultades para larealización masiva de pruebas citológicas, lo que incide en el incremento de las muertes por cáncer cervicouterino.
Como no se realizan pesquisas activas para la detección de casos con hipertensión arterial y diabetes mellitus, entre otras enfermedades, muchas veces los pacientes asisten al médico solo cuando aparecen las complicaciones graves, factor que incide en el aumento de los accidentes vasculares encefálicos, los trastornos cardiovasculares, la insuficiencia renal y otros padecimientos crónicos derivados.
Similar comportamiento ocurre con los infectados por el VIH, últimamente el número de casos diagnosticados en fase de SIDA, o sea, en estadio de plena enfermedad con presencia de signos y síntomas, demuestra el subregistro en las estadísticas con
un alto porciento de enfermos sin diagnosticar y el descontrol en el programa nacional que se lleva en el país.
La taza de mortalidad infantil (muerte de niños menores de un año) es uno de los pocos programas que mantiene su vigencia, por constituir un indicador estratégico que reporta beneficios políticos en el plano internacional, al relacionarse con marcadores de desarrollo humano, calidad de vida, entre otros aspectos. Claro, no se explica públicamente que en Cuba esta baja mortalidad se asocia a cifras astronómicas de interrupción de embarazos. Los médicos tienen la indicación de sugerir el aborto ante la presencia de embarazos con riesgos y, en determinadas ocasiones, están obligados a practicar la interrupción aún sin el consentimiento de las parejas.
Es probable que mientras continúe el apartheid en los servicios médicos y, por ende, la población tenga negado el acceso a la asistencia médica en hospitales diferenciados como el Cira García, CIMEQ, Frank País, La Pradera, Almeijeiras, Koly y otros, exclusivos para la atención de personas foráneas e integrantes de la nomenclatura, los cubanos se resistan todo lo posible a utilizar el sistema de salud, opten por la santería y la medicina verde para curarse y prevalezca la inconformidad generalizada por la mala
calidad de esos servicios.