Daily Telegraph, London
Wednesday February 21st 2007
MARIA, a plastic surgeon at a major hospital in Havana, never fails to enter theatre without her secret weapon: her own pair of scissors.
She says they are much sharper than those provided by the hospital, which she thinks are from China.
Her mobile phone has also proved useful. Towards the end of an operation recently she overcame a blackout by asking the assistant to hold up the phone to provide light as she finished off a repair to a damaged brow. “The patient was distraught but we calmed her down. We have a lot of practice at that,” she says.
Cuba’s renowned health service is in frail condition. It has been a considerable source of pride for the communist authorities since the revolution of 1959, achieving infant mortality and life expectancy rates comparable with America’s.
But it is now badly short of medicines, instruments and equipment, while many hospitals languish in disrepair. Doctors can earn more as taxi drivers, while anecdotal evidence suggests growing numbers of medics are trying to flee the country.
Maria, not her real name, accurately describes her department, which is located in a basement, as “humid, dirty and dark”. She qualified 15 years ago, shortly after the collapse of the Soviet Union robbed the Caribbean island of cheap medical imports and precipitated a decline that now appears to be only worsening. Washington has meanwhile maintained its widely criticised trade embargo. According to the American Public Health Association the blockade effectively prevents Cuba from purchasing nearly 50 per cent of new drugs, including those for cancer, diabetes, heart disease and asthma.
Critics of Cuba’s president Fidel Castro, who was forced by ill health to retire from public life six months ago and hand over power to his brother Raul, argue that his refusal to reform the state-controlled economy and its convoluted rules has helped impoverish the country. The medical profession is facing further instability thanks to Castro’s extraordinary initiative to export 30,000 doctors and dentists to 68 countries around the world, earning vital revenue for them and the nation. Some medics in Havana say the absence of so many colleagues has led to increases in waiting times at hospitals and clinics. Human rights groups have noted that doctors are forbidden from taking their children with them on the three-year stints, effectively holding them hostage to guarantee their parents’ return.