EspañolBy the time I climbed the steps of the emergency room entrance in San Miguel, Havana, I could already tell that the supposed first-class health care provided in Cuba was a myth. Hospitals in the island’s capital are literally falling apart.
Friends told me to dress “like a Cuban” and not to speak while inside, since my Argentinean accent would give me away the moment I said hello. A member of the opposition Cuban Patriotic Union (UNPACU) party came along to guide me in my journey to the core of communist-style medicine.
We entered the hospital at 10 p.m. on an ordinary Saturday night in September. Three out of the hospital’s four stories were closed. Only the ER was operational.
“We have been waiting for an ambulance for four hours,” yelled a man wearing green scrubs, who seemed to be a doctor. I sat on one of the four plastic chairs in the waiting area. My friend kept still and gestured to let me know I should remain silent and listen to the patients and their relatives.
Twenty minutes went by, and still no ambulance. The man in green scrubs remained at his mother’s side on an improvised stretcher, trying not to lose his patience. They looked like characters from the play Waiting for Godot.
The scarce equipment available gave the building the appearance of a makeshift medical camp, rather than a hospital in the nation’s capital.
I stood up and continued my tour. Two nurses stared at us but didn’t say a word as we entered an intensive-care unit, where the facility’s air-conditioned area began.
My guide — a taxi driver for tourists who don’t get to see this part of town — told me that all the doctors working the night shift are still in school. Indeed, none of them appeared to be older than 25.
The only working bathroom in the entire hospital had only one toilet. The door didn’t close, so you had to go with people outside watching. Toilet paper was nowhere to be found, and the floor was far from clean.
I saw biological waste discarded in a regular trash can. The beds had no linen, and the only equipment around was the bag of IV fluids hanging above them. All doctor’s offices had handwritten signs on the doors, and at least four patients waited outside each room. The average wait time for each was around three hours.
Orderlies were also nowhere to be seen. A young man had to push his mother on a stretcher until he reached the line of those waiting for an ambulance.
I left the hospital after a couple hours. Once outside, puzzled by the large bags the people entering the hospital were carrying, I asked my friend to explain.
“Well, they have to bring everything with them, because the hospital provides nothing. Pillows, sheets, medicine: everything,” he said.
Cuba’s Public Health Ministry runs all hospitals in the country and is in charge of centrally dictating public-health policies. The socialized medical system, delivered at no charge to Cuban patients, is a key propaganda tool of the Castro regime.
“Since the triumph of the Revolution, making sure that Cubans have free health care has become a fundamental social cornerstone,” Granma, the Communist Party’s official media outlet, boasts in an article. “This is in line with the humanism and social justice of our revolutionary process.”
Socialists and progressives outside of Cuba have also been known to gush over the island’s state-run health-care system.
In 2007, filmmaker Michael Moore released a documentary that featured US citizens who traveled to Cuba to get free medical treatment. Moore claimed they received services comparable to what ordinary Cuban citizens would have received.
“The Cuban people have free universal health care. They’ve become known as having not only one of the best health-care systems, but as being one of the most generous countries in providing doctors and medical equipment to third-world countries,” Moore says in Sicko.
Yilian Jiménez Expósito, general director of Cuban Medical Services, told Granma in an interview that “the secret lies in the medical training under a socialist system, where doctors do not view the patient as merchandise or a customer; where every citizen has a right to health care from birth to the grave, without discrimination.”
However, Hilda Molina, a Cuban neurosurgeon who turned against Castro, explained in an interview with El Cato that the whole sector is under tight government control, which shuts downs private alternatives or independent organizations.
“These arbitrary measures, aside from many other negative consequences, had a terrible impact, ethically: the sacred doctor-patient relationship was replaced with an impersonal government-patient dynamic. When patients are forced to seek care from government-sanctioned doctors and facilities, they suffer distress, whether consciously or unconsciously, immersed in a deep sensation of insecurity,” she said.
“The regime has neither provided Cubans with equality nor fairness in health care. The ruling elite, their relatives and friends, get better service than the rest,” Molina lamented.
EspañolUntil very recently, most Brazilians may not have thought that the massive protests, corruption scandals, and economic crisis would lead to an early exit from President Dilma Rousseff. However, the events of the last few weeks suggest it is a growing possibility. Both she and former President Luiz Inácio Lula Da Silva, Rousseff's mentor, have refused to acknowledge these signs, along with Brazil's increasingly grim economic, political, and social outlook. In her recent speech at the UN General Assembly, Rousseff attempted to appease the international community: "Today, the Brazilian economy is stronger, more solid, resilient, than some years ago. We have the conditions to overcome current difficulties and walk through the path to development.… We are transitioning towards a lasting, solid expansion cycle," she claimed. But reality shows a different picture. While Brazil is not on the brink of economic collapse, as is frequently the case in Latin America, most local and international analysts predict at least a two-year recession period. The Brazilian Central Bank's own forecast for 2015 is a 2.8 percent drop in GDP, and a 1 percent decrease in 2016. In addition, unemployment and inflation levels are expected to rise, which will force the government to adopt bolder, and naturally more unpopular, austerity reforms. Rousseff's approval rate, which has remained around 9 percent since June amid a historic devaluation of the national currency and the recent slashing of public spending, is likely to suffer another blow. On October 2, President Rousseff announced her administration would eliminate eight ministries, 30 secretariats, and 3,000 state-employee positions, in addition to cutting ministers' salaries by 10 percent. The decision would mean R$200 million (US$50 million) in yearly savings for the Brazilian government. How the public will react to this reform has yet to be seen, although it seems to have already appeased her main opponents in Congress. The idea of impeaching the president is now openly discussed in Congress. On September 23, Chamber of Deputies Speaker Eduardo Cunha read the procedure to review the requests for Rousseff's impeachment that have already been filed. Surely, negotiations with the majority party, the Brazilian Democratic Movement (PMDB), has allowed Rousseff to pass these austerity measures and helped her dodge impeachment and other issues for the time being. Meanwhile, the PMDB, whose members include Vice President Michel Temer, and the heads of both chambers of Congress, Eduardo Cunha and Renan Calheiros, secured control of the state institution with most funds, the Health Ministry, along with seven others. [adrotate group="8"] But how long can this weak alliance last? There is no guarantee, and the PMDB is well aware that the future of Rousseff's political life is in their hands. Lastly, the widespread belief among Brazilians that Rousseff is incapable of steering the country back on the path of economic growth and political stability is yet another indicator that her reign is coming to an end. This is further evidenced in recent polls, and this is why opposition leaders and thousands of Brazilians have been demanding her resignation. Everything points to the likelihood that President Rousseff will not make it to the end of her second term on January 1, 2019. Translated by Adam Dubove.