Setting the record straight on healthcare in Cuba

Debunking the Castro regime's healthcare claims

Cholera patients in Cuba (CNN)

Cuba has a two tiered health care system one tier for the nomenklatura and foreign tourists with hard currency that offers care with modern equipment and fully stocked pharmacies, then there is a second tier which is for the rest  with broken down equipment, run down buildings and rooms, scarce supplies, a lack of hygiene, the denial of certain services and lengthy wait times. Healthcare professionals are poorly paid and lack food.

On December 28, 2017 the Spanish news service EFE reported that the Castro regime had dismantled a network of medical officials and workers who'd adulterated a medicine for children made at the laboratories of the state-owned drug company BioCubaFarma. They replaced the active substance methylphenidate with a placebo substance in the manufacture of the drug marketed as "Ritalin." The active substance was sold on the black market. Nevertheless, The Miami Herald had an article touting the importance of importing drugs from Cuba on December 14th.

The statistics and numbers that the international community has access to with relation to the Cuban healthcare system have been manipulated by the dictatorship. Katherine Hirschfeld, an anthropologist, in Health, Politics, and Revolution in Cuba Since 1898 describes how her idealistic preconceptions were dashed by 'discrepancies between rhetoric and reality,' she observed a repressive, bureaucratized and secretive system, long on 'militarization' and short on patients' rights.  

News accounts from time to time break through the fog of communist propaganda like the EFE article cited above.

In 1997 when a Dengue epidemic broke out in Cuba the dictatorship tried to cover it up. When a courageous doctor spoke out he was locked up on June 25, 1997 and later sentenced to 8 years in prison. Amnesty International recognized Dr. Desi Mendoza Rivero as a prisoner of conscience. He was released from prison under condition he go into exile in December of 1998. The regime eventually had to recognize that there had been a dengue epidemic. 

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.”

The 2012 cholera outbreak in Cuba offered an opportunity to see how the Cuban public health system operates. The well being of Cubans is not the first item on the regime's agenda. This was demonstrated in it's response. News of the outbreak in Manzanillo, in the east of the island, broke in El Nuevo Herald on June 29, 2012 thanks to the reporting of the outlawed independent press in the island. 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 dictatorship stated that it had it under control.

In July 2013 an Italian tourist returned from Cuba with severe renal failure due to Cholera. New York high school teacher Alfredo Gómez contracted cholera during a family visit to Havana during the summer of 2013 and was billed $4,700 from the government hospital. A total of 12 tourists have been identified who have contracted cholera in Cuba.

The dictatorship in Cuba has both an incredibly effective propaganda and state security apparatus however what it does not have is an effective healthcare system for Cubans. As masters of propaganda the Castro regime can produce statistics and spin a story of wonderful medical care. Officials claimed that "this is the first cholera outbreak since soon after the 1959 revolution." However, doing a search through The New York Times archives the last quarantine for Cholera it reported in a headline on Cuba was on September 16, 1916. The last cholera epidemic in Cuba ended in 1882.

 Sherri L. Porcelain is an adjunct professor who has taught Global Public Health in World Affairs at the University of Miami for more than 30 years. She wrote an important analysis titled U.S. & Cuba: A Question of Indifference? I could not find this article on the ICCAS web site, found it initially at Professor Suchlicki's Cuba Studies Institute, but it is no longer online. This is troubling and what Dr. Porcelain's analysis reveals is disturbing.

"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."

Let us hope that this myth of the Castro regime being a health care super power be debunked before any more foreign patients or tourists are negatively impacted or that policy makers in other countries seek to copy the disastrous system in the island.

Examining Cuba and North Korea healthcare claims

"Communist political violence flowed from a utopian vision of the future, from the great goals pursued, and from the intolerance the service of these ideals inspired, as well as from an intense attachment to power. The means had to be subordinated to historically unparalleled ends that require extraordinary measures." - Paul Hollander, The Distinctive Features of Repression in Communist States

Regimes in Cuba and North Korea are totalitarian allies

 

Both Cuba and North Korea are totalitarian dictatorships that have made claims of great achievements in the area of healthcare over the course of the past month.

On June 19, 2015 the regime in North Korea said that it had "created a wonder drug which not only cures AIDS, but also eradicates Ebola and cancer."  At the same time North Korea has approximately 10.2 million North Koreans currently facing famine.

On June 30, 2015 the World Health Organization said that the regime in Cuba had "became the first country in the world to receive validation from WHO that it has eliminated mother-to-child transmission of HIV and syphilis." This is the same regime in Cuba that tried to cover up or under report dengue and cholera outbreaks jailing doctors and reporters who warned of the outbreaks at the time in order to preserve a false image of its healthcare system. The dictatorship has not reported any new cholera cases since September 2014 but according to the Public Health Agency of Canada the government of Canada reported a case of cholera in a traveler who returned from Cuba in January of 2015. Tourists have been stuck with the bill in Cuba after contracting cholera on vacation.

When evaluating the above claims by both dictatorships it is important to recall the nature of these type of regimes. The website Boundless which seeks to provide a "cloud powered education" gives a complete definition of totalitarianism which includes the following observation:

"Totalitarian regimes stay in political power through all-encompassing propaganda campaigns (disseminated through the state-controlled mass media), a single party that is often marked by political repression, personality cultism, control over the economy, regulation and restriction of speech, mass surveillance, and widespread use of terror"

Now the claim made by the regime in North Korea was ridiculed by the mainstream press and shows that the regime is not as sophisticated in its propaganda messaging as their Cuban counterparts.

The regime in Cuba used the World Health Organization (WHO) to promote a false narrative of the Cuban healthcare system exploiting a misleading validation process which the WHO described on their website:

"As treatment for prevention of mother-to-child-transmission is not 100% effective, elimination of transmission is defined as a reduction of transmission to such a low level that it no longer constitutes a public health problem. An international expert mission convened by PAHO/WHO visited Cuba in March 2015 to validate the progress toward the elimination of mother-to-child transmission of HIV and syphilis. During a five-day visit, members visited health centers, laboratories, and government offices throughout the island, interviewing health officials and other key actors. ... The validation process paid particular attention to the upholding of human rights, in order to ensure that services were provided free of coercion and in accordance with human rights principles."

Before anyone travels to a totalitarian regime they should first read Paul Hollander's Political Pilgrims: Western Intellectuals in Search of the Good Society if they do not want to be manipulated.  This book studies and catalogs the strategies and tactics that these regimes use to control what one sees visiting their respective countries and what the unintended consequences are for its victims: i.e. the people who have to live there. Katherine Hirschfeld, an anthropologist, in Health, Politics, and Revolution in Cuba Since 1898 who spent a lot longer than five days in Cuba studying the healthcare system, contracted dengue while there experiencing first had the 'discrepancies between rhetoric and reality,' She observed a repressive, bureaucratized and secretive system, long on 'militarization' and short on patients' rights. 

These false or exaggerated healthcare claims are a central element to both totalitarian regimes' justification for continuing their repressive systems and hanging on to power using "extraordinary measures." 

Questions for Hugo Chavez on the Health Care System in Cuba

José Daniel Ferrer García

Earlier today on his twitter account former Cuban prisoner of conscience José Daniel Ferrer García, who was unjustly imprisoned from March 2003 through March 2011, and continues his vocation as a Cuban human rights defender
and pro-democracy activist asked a number of open questions to Hugo
Chavez, of Venezuela, currently in Cuba recovering from surgery:

"Chavez recently said Cuba has one of the world's best health systems. I wonder what he'd say if he were an ordinary Cuban?"

"What would Chavez say of the Cuban health system if he were family of one of the patients who died in Mazorra?"

"Continuing with Chavez. What would he say of Cuban health care if he were a widower of one of the women who died in the Palma Soriano maternity hospital?"

Jose Daniel then concludes with a tweet that placed the above questions into the proper context: "The Cuban health system, like so many other things, works very well, yes, for foreigners and the nomenklatura."

Foto from EFE of Cuban healthcare facility today

The real score on Cuban healthcare and prenatal care

Over the past couple of years this blog has had several posts on the myths about the healthcare system in Cuba outlining both the horrors committed against patients in places like Mazorra; the lack of decent facilities and the systematic effort by the regime to cover up these realities despite exposure by wikileaks. On Saturday, May 21, 2011 a blog post by Claudia Cadelo of Octavo Cerco titled One More Number in Statistics (Un número en la estadística) succinctly exposes the reality lived by a Cuban woman undergoing a pregnancy on the island. Below the English translation is reproduced and the original Spanish can be found here.

One More Number in the Statistics

by Claudia Cadelo

Breakfast 7:00am: 1 C. coffee with milk, 1 tsp sugar, 1 fruit, 1 bread, 1 tsp. butter or mayonnaise. Lunch 1:00pm: 3 large spoons rice; 1/2 C. vegetables; 1/2 C. squash, beets, or carrots; meat, chicken, fish, egg or liver; salad, eat freely; 4 tsps. jam. Dinner 7:00pm ( same as lunch). Snacks 10:00am; 4:00pm; 10:30pm: 1 C milk or yogurt, 1 tsp sugar, fruit.

E. is 38 and pregnant. She feels like one more number in the statistics. The other day she called me when she was leaving the polyclinic to say she was coming over. They couldn’t do any more. Half the tests couldn’t be done because they didn’t have the reagents, even though they sent the prescription paper back smeared with someone else’s blood. She’d been up since five in the morning and at ten still hadn’t had breakfast, and to top it off the doctor asked her, “Honey, why did you wait so long to give birth? Now I have to do an electrocardiogram.”

The first thing she said when she saw me was, “I thought the state of education was bad, but now that I’ve come up against the public health system...” E. is like me, very small, but much skinnier. Before her pregnancy she weighed 89 pounds and now, at two months, she weighs 113 and her hemoglobin count is 12.5. Still, the nutritionist thinks she is underweight and has recommended “moving into a maternal home.” She gave her a copy of a diet to follow to the letter. When she showed it to me I started to laugh, but to her there was nothing funny about it.

She has to get up at seven in the morning to have breakfast and this first meal of the day includes a tablespoon of mayonnaise, whose nutritive properties are unknown to me. Throughout the day she must must meet the standard of six large spoons of rice and two ladles of beans (half at lunch and half at dinner, every day until the baby comes). Meat is not defined by quantity and she must eat a half cup of guava jam every day.

I wonder if the diet is to nurture her or to fatten her up. Probably the doctor isn’t authorized to recommend eating certain products like meat or much fish, but at least they should have the decency not to put pregnant women on diets designed to fatten turkeys to make foie gras. In response to the psychologist’s long awaited, “How do you feel?” E. answered, “Fine, but I’d feel better if I didn’t have to come to this polyclinic any more.”

http://octavocercoen.blogspot.com/2011/05/breakfast-1-c.html