Apartheid en Cuba
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    The Two Faces of Medicine in Cuba / Iván García

    The Two Faces of Medicine in Cuba / Iván García
    Iván García, Translator: Unstated

    Dennis, 39, and his wife Elvira, 37, spent seven months trading off
    between sleeping on the floor and on a mat full of patches, next to the
    bed of their 10-year-old son, who was involved in a complex surgery at
    the Juan Manuel Marquez Pediatric Hospital, located in Marianao.

    They have relatives in Havana, but their home is in Cardenas, Matanzas
    province, 140 kilometers from the capital, and for years, due to the
    precarious health of their only child, they have lived somewhere between
    the two cities.

    The Marianao Pediatric hospital, freshly painted, seen from the outside
    does not look it, but it needs a careful building maintenance. The
    corridors leading to the neurosurgery room are completely dark.

    The few air conditioners that still work leak water that floods the
    halls. When a child is admitted, families have to carry buckets,
    toiletries, televisions and food.

    The hospital does not guarantee these supplies. Food intended for
    patients and those with them is a real hodgepodge. "The least bad is the
    medical staff, they are industrious and capable, but if you want to get
    good care, you bring gifts and snacks to every consultation," says Dennis.

    Also scarce are the latest drugs. The doctors in Cuba usually have two
    types of treatment, depending on the patient's pocket.

    If you're short of money and have no relatives outside, you are
    prescribed drugs sold in pharmacies in the national network, usually of
    low quality.

    If you tell them you have relatives across the pond, in the United
    States or other countries, the doctor offers a wide range of advanced
    drugs. The Cuban doctors have Internet and are quite well-informed.

    Alternatively, if you receive remittances from friends or family abroad,
    or have access to foreign exchange, you can purchase in hard currency,
    in any of the dozen scattered International Pharmacies in Havana. They
    sell a wide range of drugs produced in the capitalist laboratories

    If the Marianao Pediatric urgently needs a hand, what about the other
    centers in Havana. When you visit dilapidated hospitals like the Miguel
    Enriquez in Luyano, or the ancient Dependientes, on 10 de October
    Street, you will miss the tiresome governmental discourse that tells us
    that Cuban public health is one of the best on the planet.

    Also needing a standing 8 count are several rooms of the Calixto Garcia
    or Emergency, on Avenue Charles III. The floors and bathrooms with no
    sanitation, peeling walls, leaking roofs, rude manners of a segment of
    the nursing staff, shortage of surgical instruments and little
    professionalism in some physicians, have resulted in health care in Cuba
    that is currently in free fall.

    When an ordinary citizen should be hospitalized or receive extensive
    treatment, cross your fingers. Many brilliant specialists are serving

    And those left to fill those positions, are overworked. Add to that a
    doctor on the island, on average earns a monthly salary equivalent to
    $30, breakfast coffee without milk and they sometimes have to spend two
    hours in a crowded stop to board the buses that take them to the
    hospital or clinic, then the best option is to not get sick.

    Norge, 28, with chronic asthma, wants to be well treated and so he
    became friends with the doctors and nurses treating him. "Whether I'm
    seeing them or not, I visit them and give them gifts. Once, I gave each
    a leg of mutton."

    If most of Havana's clinics and hospitals are crying for maintenance,
    you can not say the same of Hermanos Ameijeiras Clinical-Curgical in
    Central Havana, within walking distance of the Malecon.

    This hospital is in good technical condition and a simple look around
    notes the hygiene. One reason may be that is one of the flagship
    institutions of public health in Cuba, in addition to having several
    floors devoted to the care of foreign patients.

    But if you want to see clinics like those you see in the U.S. TV shows
    transmitted on national television, look at the Cira Garcia Central
    Clinic or the Center for Medical-Surgical Research — the famous CIMEQ —
    both located in Playa municipality.

    You will first see rooms that are conspicuous by their cleanliness, a
    quality balanced diet, a fleet of well equipped ambulances, security
    guards and top-flight doctors. All to be paid for in dollars, euros or
    pesos convertibles.

    The ministers and generals are entitled to be treated at these clinics.
    Or foreign leaders like Hugo Chavez, operated on three times at CIMEQ,
    to stop the cancer he suffers.

    For them, Cuban health care is a real gem. Dennis and Elvira, who have
    spent seven months sleeping on the floor of a pediatric hospital, think

    March 22 2012


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