Posts Tagged ‘health care’

The hearse led a procession through the streets of a Cuban town then out into the countryside.  It was converted from a 1980’s era Chevy S-10 blazer, a rare model to be found in Cuba where nearly all American-made cars predate the 1959 revolution.  But a few foreign embassies and consulates imported cars for their own use, and sold them to Cuban businesses when they were ready for newer replacements.  Behind the hearse was a ‘56 Buick, driven by Yosmani, a black-market taxi driver.  Today there was no charge.  Today Yosmani was transporting his childhood friend and the friend’s parents and in-laws.   The rest of the families, mostly women and children, rode behind on the third vehicle.  They were tossed around on the back of ‘53 International flatbed truck. It spewed purple smoke that swirled into clouds of its own dust.  Along the sides of the truck, six or seven older men were riding bikes.  The last car in the procession was mine, a 2005 Hyundai rental.  I kept some distance trying to avoid the dust while listening to the heated conversation in the back seat.

The funeral was for a baby that had not survived childbirth.  I knew the baby’s father from a previous visit and had heard that his wife was in the hospital.  There were complications, so the mother had been hospitalized for the last few weeks of her pregnancy. The hospital reported to the father that the baby was too weak to make it through the surgery and died during the C-Section.   The mother was still in the hospital, so this young man was here to bury his son and then return to her bedside. 

The local pastor and his wife, Silvia, were riding in the back seat of my car and their 16 year old son, Andreis, was riding in the front with me.  Silvia was talking very rapidly.  I could only tell that she was talking about how the baby had died, and that she was angry and sobbing.  The pastor was quiet.

“What are they saying,” I asked Andreis.

Andreis translated his mother’s meaning into a slower and simpler version of Spanish so that I could understand. 

“The hospital reported that the baby died during the surgery,” he said.  “But when the mother regained consciousness after the surgery, she told her husband that this was not true.”

“What happened?” I asked.

 “When the baby started to come, there weren’t enough doctors available,” he said. “By the time they got to her into surgery, the baby had already died.” 

Silvia slumped into her husband’s arms and began to sob. I could see in my mirror that with each sob, she pounded her small fist onto her husband’s chest..

“My mother is angry because the government has sent too many Doctors – the best doctors – to other countries,” he said.

“Cuidado,” the pastor said to his son.  Be careful.

“No, he should know the truth,” Silvia said through her tears.

As I maneuvered the car around washed out holes that I thought might swallow up my little car, the pastor told me about the situation in more general terms.  He said that several years ago the government opened up its Medical Schools to any students who wanted to attend, for free.  “They are good schools,” he said, “but as a result of this open system Cuba has many fine doctors, many mediocre doctors, and some really bad doctors.”  He then told me that recently, when the government agreed to send hundreds of doctors to Venezuela, Bolivia and other countries, he sent Cuba’s finest.  In most cases they went willingly.  Outside of Cuba they could make more money for their families.  In other cases they went so that they would not be sent to less desirable places as punishment for not accepting the assignment. 

Silvia added, “He’d rather look important to other countries than take care of his own people.”

The car grew silent except for the gentle sobbing in the back seat and the occasional roar of the truck engine ahead. 

I remembered the first billboard I saw when I arrived in Havana.  You couldn’t miss it on the road from the airport into the city.  I had the taxi driver stop so that I could take a picture.





No wonder Cuba reports such great health care statistics, low infant mortality rates, high life expectancy averages, etc.  No wonder Michael Moore chose to highlight the Cuban health care system in Sicko.  Statistics and billboards tell good stories when not everybody counts. 

I found myself hoping that the grieving father in the car ahead had never seen that billboard – the one that would say to him:  


When the procession stopped, the pastor and I helped the women and children down from the bed of the truck.  They hurried to gather around a family tomb where the mason was preparing concrete to seal the cover. 

I saw the child’s father sitting on a bench 30 feet away with his face in his hands.  I walked to him and asked, “are you going to join them?”

He stood up, moved very close to me and whispered, “I’ll say goodbye to my son when I can stand by his tomb with his mother.”

After we loaded everyone back on the truck I agreed to take the pastor to the hospital to visit the baby’s mother. 

“I’d like to see the hospital,” I said.  “Can I go in with you?”

“I don’t think so,” he said. “It’s only for Cuban patients and their families.  I’ll be allowed in with my credentials as a pastor, but I doubt that they would let you inside.” 

He could tell that I was disappointed, so he began to help me see the hospital through his eyes. 

“Like all of health care, the hospitals in Cuba are ‘free’,” he said using air quotes, “but still it’s best if you go with gifts or money for the staff.”

“And you don’t send a relative there alone,” he said.  “If you want your son or mother to get fed and get good care, you send an advocate, a family member, to stay with them.”

As we drove toward the city, he told me of his friend who had emergency intestinal surgery.  After the surgery, the unconscious man was rolled out of the operating room on a gurney with doctor instructions and antibiotics tucked between his legs. When he arrived in his room, the medicine and instructions were gone – stolen to sell on the black market.  By the time the family found the doctor and convinced him to write a new prescription the man had gone for 24 hours with no medication and had acquired high fevers.

The pastor directed me to the parking lot of a large four-story high building.  If there were signs, I had missed them and there was no way to tell that it was a hospital.  The block building’s exterior was crumbling and had not been painted for decades.  Clothes and sheets hung from open or missing windows and there was obviously no air-conditioning.  

“This is it?” I asked.

“This is it,” he said without expression.  “There are better hospitals in the bigger cities.  Some are cleaner and don’t have insects, cockroaches or rats.  There are better hospitals, but there are worse hospitals as well.”

Read Full Post »