“Cuba has the best doctors in the world!”, proclaimed Diego Armando Maradona, who frequently traveled to the island to treat his drug addiction and obesity problems. Former Ecuadorian President Rafael Correa also received treatment in Cuba, as did Gustavo Petro, Colombia’s socialist presidential hopeful. Hugo Chavez died in a Cuban hospital, which in itself does not speak badly of the health system, since even the best bakers sometimes burn their bread.
Communists from all over the world and friends of the Castros have received Cuban medical care and have contributed to spread the myth that the health system is the main achievement of the revolution. And it probably is for members of the communist elite, their friends abroad and for tourists from developed countries who travel to the island for treatment. Things are less glorious for the average Cuban citizen, because in Cuba there are actually three health systems.
The three health systems in Cuba
First, there is the one designed for foreigners traveling for medical care, which has become a major source of foreign exchange, bringing in as much as $8 billion to the state annually.
A surgery to increase breast volume costs $1,400 at Havana’s Cira Garcia Central Clinic, reserved for foreigners, compared to more than $6,000 in the United States, $4,000 in Great Britain or $2,500 in Mexico. Several hospitals – such as Hermanos Ameijeras and Gonzales Coro Hospital – have “international wards” and some hotels have specialized in receiving foreign patients.
The second system is that of the communist elite – the nomenklatura – party cadres, military, artists, writers and intellectuals sympathetic to the regime. As in any egalitarian system, some are more equal than others, and the highest-ranking party leaders and cadres receive the level of care reserved for foreigners who pay in hard currency. Lower-ranking members of the nomenklatura also receive good medical treatment, although hospital care conditions are quite modest.
The third health system is reserved for ordinary Cubans, with clinics and hospitals that are crumbling due to lack of maintenance. Since 2010, more than 64 hospitals have been closed, which represents one third of the country’s hospital capacity.
The shortage of supplies and medicines, even the most basic ones, is dramatic. Patients who manage to be hospitalized must bring their own sheets, towels, soap, food, etc. Cuba boasts of having many doctors in relation to its population, but in the clinics and hospitals these doctors have very little to work with, since the equipment is outdated, deteriorated or non-existent.
The other problem of the Cuban hospital system is that it has no transparency whatsoever. While in Latin America on average neonatal deaths are 1.04 per 1,000 infants, in Cuba this figure for 2015 was 6 per 1,000. Cuban hospitals to decrease the statistic did not choose to ask for more investment from the dictatorship in prenatal care, but to report the death as that of an already born infant. This type of number crunching is common in the Cuban health system, which is why many of its indicators are simply not reliable.
Another factor to consider is the means Cuba resorts to in order to keep its health statistics favorable. Pregnant mothers in Cuba are heavily monitored by the regime and are pressured to abort in case ultrasound scans find any kind of condition in the infants, some mothers are forcibly interned in the so-called “Maternity Homes” to monitor their pregnancy, even if they prefer to stay at home.
Covid-19 destroyed the myth of the Cuban health system
The tip of the iceberg that revealed the precariousness of the Cuban health system is the current Covid-19 crisis, not only because of the number of cases per day, which already exceeds 6,000 infected, but also because of the lack of supplies to treat patients. While hospitals are overcrowded, doctors have little to do to treat their helpless patients because they have no medicines.
Cuba was overly dependent on drug supplies from Asia and with the emergence of Covid-19 the supply has been cut off and the country is too poor to diversify its export sources.
A good part of the contagions and deaths could have been prevented if the Diaz-Canel regime had subscribed to the Covax agreement, designed to supply doses of vaccines like AstraZeneca, but to shield the country from “neoliberalism” and the Bill and Melinda Gates Foundation, the regime preferred not to opt to receive the 2 million doses it was entitled to and condemn its population to the martyrdom they are suffering today.
Instead, the Cuban regime, without the resources of a solid pharmaceutical industry like the American or European ones, preferred to embark on the production of its own vaccine, Abdala, whose efficacy has not been proven by any organization outside the Cuban regime.
In addition to the collapse of the hospital infrastructure and the shortage of all kinds of medicines and treatment resources, there is also a shortage of medical personnel, since almost one third of the health professionals work abroad, in 62 countries, as slaves in white coats, since the regime confiscates 75% of their salaries.