Saturday, March 28, 2020

Setting the record straight on the Cuban healthcare system and medical missions program

Debunking the Castro regime's healthcare claims

3 patients who died in Cuba of exposure at a hospital facility due to neglect in 2010
There are many myths that the Castro regime has successfully propagated over the years. The international community deeply believes one of the biggest and most dangerous whoppers, that Cuba’s healthcare system under the current communist system is a success that turned the island into a medical super power. This fabricated fiction needs to be addressed to save lives both inside and outside of the island at this critical time. 

These are some of the facts that Havana has spent decades covering up.

The healthcare system that existed in Cuba prior to 1959 was superior to what came after. Professor James W. McGuire and Laura B. Frankel in their paper published in the Latin American Research Review, “Mortality Decline in Cuba, 1900-1959: Patterns, Comparisons, and Causes” found that “Cuba's progress relative to other Latin American countries at reducing infant mortality was even greater from 1900 to 1960 than from 1960 to 1995. During the earlier period, Cuba led all Latin American countries for which data are available at raising life expectancy and reducing infant mortality. From 1960 to 1995, by contrast, it came in fourth and fifth respectively.”

Healthcare in Cuba is not free, nor are the medical missions sent around the world, and at times can be expensive, and unforgiving. Tourists visiting Cuba who have become ill found that they were presented expensive bills for medical care received.

In the summer of 2013 Sheila Dumbleton, age 57, fell ill six days into a birthday trip to Cuba was hospitalized before passing away. “Sheila was left to die because we had no money to pay for treatment, it’s as simple as that. If she had fallen ill in this country she would still be here,” said her husband Ray Dumbleton, who is from the United Kingdom, adding, “As soon as the hospital knew we couldn’t pay, they just left her to deteriorate. All the doctors kept saying to us was ‘payment, payment’ but we simply didn’t have that sort of money to give them.” He wasn’t even allowed to bid farewell to his wife when she died. To add insult to injury, the Cuban hospital wouldn’t release the body, and threatened the husband with prison if he didn’t come up with the $26,700 bill.

Ray and Sheila Dumbleton
Cuba's health tourism effort has roused bitter reproach from the nation's critics, who accuse the Castro regime of creating an apartheid system of health care, in which foreigners - and Cuban party elite - get top-class service while average Cubans must make do with dilapidated facilities, outdated equipment and meagerly stocked pharmacies.These greatly contrast with Cuban elite hospitals promoted by "health tourism" enterprises such as SERVIMED.

Hilda Molina, one of Cuba 's most noted scientists, founder and a former director of Havana 's International Center for Neurological Restoration broke with the regime and resigned both from her high-level position there and as a member of Cuba 's National Assembly to protest the system of medical apartheid.


In a long document smuggled out of Cuba after her resignation, Dr. Molina describes a campaign by Cuba to present itself as a "medical superpower" attractive to foreign patients looking for bargain-basement health care. Instead, she writes, these patients have often found themselves subject to substandard, sometimes fraudulent medical care: "The lack of adequate professional qualifications, the absence of medical ethics, and the drive toward financial enrichment characterize Cuba 's medical system and often yield unfortunate results."

According to Dr. Molina, "Foreign patients are routinely inadequately or falsely informed about their medical conditions to increase their medical bills or to hide the fact that Cuba often advertises medical services it is unable to provide." 

"Free" healthcare in Cuba is characterized by a lack of resources and often times neglect. On January 15, 2010 The New York Times reported the confirmed deaths of at least 20 mental patients at the Psychiatric Hospital in Cuba, known as Mazorra, due to "criminal negligence by a government characterized by its general inefficiency," a day later the Cuban government confirmed that 26 patients had died due to “prolonged low temperatures that fell to 38 degrees.”

Cubans that express disagreement with their political leaders, and government policy have been known to be punished by having medical care denied.

Human rights defender Sebastián Arcos Bergnes, in 1992 was charged with "enemy propaganda" and "inciting rebellion," he was sentenced to four years and eight months in prison. Sebastian was transferred to Ariza Prison in  Cienfuegos Province,  more than 130 miles from Havana, where he was imprisoned alongside dangerous criminals and systematically denied medical attention. In 1993 the regime offered Sebastian a deal: He would be released immediately if he only agreed to leave the island for good. Sebastian rejected the deal, choosing prison in Cuba over freedom in exile.



Sebastián Arcos Bergnes in front of his home on May 31, 1995 following his release
Following an international campaign that included his designation as an Amnesty International prisoner of conscience and a request by France Libertés, the organization founded by former French first lady Danielle Mitterrand, Sebastian Arcos was released in 1995. A few weeks after his release, Arcos was diagnosed with a malignant tumor in the rectum, for which he had previously been denied medical care in prison. After a Cuban doctor was fired from his post for diagnosing Arcos, he traveled to Miami for further care. Sebastián Arcos Bergnes died in Miami on December 22, 1997


Sirley Avila Leon.  Sirley was a true believer who grew up in the revolution and was a member of a local municipal assembly. She believed the claims that free education was a right for all Cubans. This belief left her an invalid and nearly led to a violent death. She lobbied and agitated for a school to be opened in her municipality so that the children there would not have to trek 5.6 miles to go to class and then trek the same distance back to get home.


Sirley Avila Leon
On May 24, 2015, Sirley Ávila León was the victim of a brutal machete attack that cost her her left hand and also left her right upper arm nearly severed and knees slashed, leaving her crippled. She was denied adequate medical care and was told quietly by medical doctors that if she wanted to get better she would need to leave Cuba. The regime had been embarrassed by a campaign she organized to keep a school open. She arrived in Miami on March 8, 2016 unable to bend her legs, or use her remaining had.Thanks to a team of medical doctors treating her, by September 2016 Sirley had regained the use of her hand, and was able to walk short distances.

Lady in White Xiomara Cruz was arrested on April 16, 2016 for speaking out during a human rights demonstration in Havana's Central park. She was placed on parole in January of 2018. She was re-arrested in mid-September 2018 under the charge of being "threatening." On September 19, 2018 she was tried and sentenced to one year and four months in prison. She was sent to a prison 400 kilometers from her home. This was an added hardship for her family to visit her, and keep an eye on her well being.
Xiomara de las Mercedes Cruz Miranda before and during her jailing.
Over the course of one year in custody of the Castro regime her health radically declined. Rashes that appeared on her body in June 2019 that Cuban medical doctors in Ciego de Ávila claimed to be unable to diagnose. In mid-July she was returned to Havana to La Covadonga hospital

On August 8, 2019 she was transferred to intensive care. Cuban dissident Angel Juan Moya posted videos of interviews from August 6th and August 7th with doctors at the hospital. Family members complained that they are receiving differing diagnoses and her situation continues to worsen. Xiomara was in intensive care and doctors were saying that it could be lung cancer. A doctor refused to update the family saying: "that he did not want to see those people."


Near death she arrived in Miami on January 21, 2020 on a humanitarian visa, and was immediately placed in intensive care.

Xiomara de las Mercedes Cruz Miranda arrived in Miami on January 21, 2020
This practice of rationing care based on political fidelity has also been practiced overseas. Nicholas Casey’s article “‘It Is Unspeakable’: How Maduro Used Cuban Doctors to Coerce Venezuela Voters” published in The New York Times on March 17, 2019 interviewed Cuban doctors haunted by what the Castro regime required them to do in their overseas assignments.

Dr. Yansnier Arias “had been sent to Venezuela by the Cuban government, one of thousands of doctors deployed to shore up ties between the two allies and alleviate Venezuela’s collapsing medical system. But with President Nicolás Maduro’s re-election on the line, not everyone was allowed to be treated, Dr. Arias said. A 65-year-old patient with heart failure entered his clinic — and urgently needed oxygen, he said. The tanks sat in another room at the ready, he recalled. But he said his Cuban and Venezuelan superiors told him to use the oxygen as a political weapon instead: Not for medical emergencies that day, but to be doled out closer to the election, part of a national strategy to compel patients to vote for the government.”

Dr. Yansnier Arias spoke out on abuses on Cuban medical missions
Casey reported that “16 members of Cuba’s medical missions to Venezuela — a signature element of relations between the two countries — described a system of deliberate political manipulation in which their services were wielded to secure votes for the governing Socialist Party, often through coercion. Many tactics were used, they said, from simple reminders to vote for the government to denying treatment for opposition supporters with life-threatening ailments.”

Not all the Cuban personnel, dressed up as doctors to treat patients around the world, are in fact doctors. Raúl Manuel, a Cuban doctor now in Brazil described in the same New York Times article how in 2015 on Election Day “he was sent to an opposition stronghold. When early returns showed the opposition ahead, a gun battle broke out. … After the shootout, Dr. Manuel said he returned to the clinic, shaken, only to learn that government officials from other departments — including the sports and culture agencies — were going out, too, posing as doctors. ‘We, the doctors, were asked to give our extra robes to people,’ he said. The fake doctors were even giving out medicines, without knowing what they were or how to use them.”

But it was not only for the votes. Sending doctors to work abroad in other countries is Cuba’s biggest export bringing in $11 billion per year to the dictatorship. The Cuban government signs secret agreements with these countries and in the case of Qatar, keeps 90% of Cuban doctors’ wages.

Cuba’s Communist dictatorship, like their Chinese counterparts, covered up epidemics endangering the lives of many. This was most recently revealed in 2019 when Yale School of Public Health’s Nathan Grubaugh and his colleagues estimated that the total cases of Zika in Cuba in 2017 alone would have been 5,700, and added that the “2017 Zika outbreak in Cuba was similar in size to the known 2016 outbreaks in countries with similar population sizes.”

Duane Gubler at the Duke-NUS Medical School in Singapore on January 8, 2019 said “Cuba has a history of not reporting epidemics until they become obvious.” Doctors and journalists who had spoken out warning about past outbreaks of dengue in 1997 and cholera in 2012 have been punished and some were jailed. Elderly Cubans have borne the brunt of revolutionary responses to crises. Between 1982 and 1993 during the “special period” according to a letter published in the Canadian Medical Association Journal (CMAJ) on July 29, 2008 in Cuba the death rate among the elderly increased by 20% from 1982 to 1993.”

In 1997 a Cuban doctor was silenced for warning about a deadly dengue epidemic. Dr Desi Mendoza Rivero, married with four children at the time, was arrested on June 25, 1997. On November 28, 1997 he was sentenced to eight years in prison for "enemy propaganda." Amnesty International declared Dr. Mendoza Rivero a prisoner of conscience and campaigned for his freedom. He was released on November 20, 1998 due to health reasons following the visit of the Spanish Foreign Minister, under the condition that he leave Cuba for exile in Spain.

First official report to the World Health Organization of the dengue outbreak was six months after initial identification made by the jailed and later forcibly exiled physician. Mendoza Rivero's reports were eventually confirmed. This episode would have a chilling effect on other doctors coming forward.

News of a cholera outbreak in Manzanillo, in the east of the island, broke in El Nuevo Herald on June 29, 2012 thanks to the reporting of an independent reporter in the island. Calixto Martinez, the independent Cuban journalist who broke the story was jailed. The state controlled media did not confirm the outbreak until days later on July 3, 2012. The BBC reported on July 7, 2012 that a patient had been diagnosed with cholera in Havana. The Cuban government stated that it had it under control and on August 28, 2012 said the outbreak was over.

They are doing it again now with the Coronavirus outbreak
Havanatour, tourist agency owned and run by the Cuban military, continued to pitch Cuba as a travel destination and posted tweets in mid-March claiming that Coronavirus does not replicate at high temperatures, that the island is now 29-32 degrees Celsius, and that it was safe to travel there.


On March 20, 2020, The Sun published "WHERE CAN I TRAVEL? Coronavirus travel advice: The full list of holiday destinations Brits can and can’t travel to" by Lisa Minot with a long list of countries either banning or putting strong restrictions on travel, but Cuba was still open for business:
"Cuba - No restrictions on entering the country. Screening on arrival, if presenting symptoms you may be taken to health facilities in Havana." 
This at a time when Cuba is suffering from shortages of soap, and toiletries for Cubans in the island, and conditions in hospitals that do not meet minimum hygiene standards.

Translation:“Cuba is bathed in the rays of the sun all year and taking pertinent measures we have greater strengths to face COVID-19. From the #Caribbean it’s #Cubaisasafedestination. Come visit with #Havanatur.”
Cuban dictatorship officials confirmed that a 61 year old Italian tourist had died of SARS-CoV-2 on March 18, 2020 and a 45 year old Russian tourist with diabetes died of SARS-CoV-2 on March 25, 2020. The true scope of the SARS-CoV-2 outbreak in Cuba is still not known but at a minimum numbers in the tens of thousands, and people are dying. On March 24, 2020 the doors were officially closed to international tourism amidst rising dissent in the population. Mark Fitzpatrick, an American tourist, has gone missing. According to Cuban official media there are 9,000 tourists stuck in Cuba, and being called to quarantine.


 
Without human rights, healthcare is compromised.
Sherri L. Porcelain, an adjunct professor who taught Global Public Health in World Affairs at the University of Miami for more than 30 years, wrote an important analysis titled "U.S. & Cuba: A Question of Indifference?"  Dr. Porcelain's analysis revealed that Cuban healthcare system is not the panacea that it is billed as:
"Investment in the health of people includes protecting human rights. This means allowing the health community to speak out and not to be jailed for releasing information about a dengue epidemic considered a state secret, or not sharing timely data on a cholera outbreak until laboratory confirmation of travelers returning from Cuba arrive home with a surprising diagnosis. This causes me to reflect upon my personal interviews where the remaining vigor of public health actions in Cuba exists to fight vector and water borne diseases. Sadly, however, health professionals are directed to euphemistically use the vague terms of febrile illness in place of dengue and gastrointestinal upset for cholera, in contradiction to promoting public health transparency."
Cubans today are outraged that officials waited until March 24th to take substantive measures to mitigate the spread of the coronavirus, and they fear that the dictatorship is preparing to cover up a humanitarian disaster at home while exporting their doctors abroad.

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