Tuesday, October 11, 2011

Inside a Cuban hospital

   I have seen the inside of a Cuban hospital the hard way--as a patient. There is a story attached that helps to explain why I have not made a posting for more than two weeks. And like all stories, it has a beginning.

Santa Clara is in the middle of  Cuba

   Wendy and I badly needed a break (no pun intended). Also, our 40th wedding anniversary was coming up, so we wanted to treat ourselves. Thus we booked a trip to Cuba. We had never been there before and we wanted to experience that country. We got a little more than we bargained for.
The causeway can be seen in left of map

   Our resort was located on  Cayo Santa Maria, an island on the  northern coast, connected to the mainland by a 48-km causeway. The nearest major airport is in Santa Clara, almost 120 km from the hotel.
   Our flight did not arrive until about 8 pm, and it was almost 11 when we got to the hotel. We then had to find our cabin.  The resort was not well lit. And then we discovered our key did not work. In the dark, right near the lobby, I fell flat on my face. It had been raining and everything was slick.

A satellite view of Cayo Santa Maria with is many resorts

   The people in the lobby called a doctor and I was soon brought to the International  Clinic about 3 km away. After an x-ray revealed that my arm was broken right near the shoulder, it was decided that I would have to be brought to the hospital in Santa Clara by ambulance, since the clinic was unable to set the arm.
   Wendy went along and we arrived at the hospital at about 2:30 in the morning. There it was decided to immobilize the arm and wait until the displaced bone could be set under a general anesthetic later that day.
   Another x-ray followed, together with a blood test and an ECG. These procedures required knocking on doors and waking up the technicians, who were sleeping in these rooms. The equipment was old, but it still worked. This typified the hospital.
   Then I was brought to my room in the international wing. The room was clean, although it was in disrepair. The TV worked, after a fashion--there were only four channels, all in Spanish and very snowy. I had no reading material with me, and thus I had a lot of time to reflect and pray.

 Our resort--we stayed in cabin 16, with an ocean view

   Surprisingly, I was not angry. I regretted that my vacation was starting in an inauspicious way, but I was stoical during that first day. About 1 pm I was brought to surgery. In order to separate the clean surgery from the rest of the hospital, a ladder had been placed on its side in the hallway, my gurney was put on one side and another gurney on the other, and I was shifted from one to the other.
  In the recovery room, where I went before and after the surgery, there was a wall clock that did not work and was upside down to boot. Yet the hospital was remarkably clean.
  It was not really surgery; the bone in my arm was aligned better, although not perfectly. There was a team of ten doctors and nurses. A few bulbs in the lamp over the surgical table were broken. The arm was then put into a cast that covered not only the arm but also half my chest. I noticed that right away when I woke up.
  Soon I was brought back to my room, where I later enjoyed a good meal. Wendy had gone back to the resort, where she slept briefly and then sent emails to our children. She was unable to reach the insurance company, but our daughter did and initiated the claim procedure. Wendy came back to the hospital that evening by taxi--about 120 km--and stayed the night. She too received a plate of food.
  The next morning, after arranging funds to pay for the hospital and the clinic, we took another taxi back to the resort. I had missed only about 36 hours of our vacation.

   Nevertheless, I enjoyed our stay there. The beach was beautiful, even though I was unable to enter the water to swim because of my cast. We were able to walk for many kilometers. And the food was reasonable--after all, this is Cuba. We have lived in many countries and the food in Cuba compares well with that elsewhere.
   The hospitals do too. I grew to appreciate the Cuban medical system. The doctors and nurses are among the best in the world, even if their equipment was old and obsolete. They are well trained and in high demand elsewhere in the world. For example, Cuba exports them to Venezuela, in return for oil.
  At the resort I learned that while the hotel staff receive tips in hard currency or the convertible peso, doctors and nurses only receive a minimal salary in ordinary pesos. My stay in the hospital meant that the hospital was able to earn some money. Whether the doctors and nurses received any of it, I do not know. I hope they did.
   Medical care is free for Cubans. It is basic, but adequate, according to reports. Some people allege that only foreigners receive good care in Cuba, but that is not true. We have to pay, but the fees are minimal as compared to what American hospitals charge.
   Would I go back to Cuba again? Definitely! But next time I hope to avoid Cuban hospitals.


  1. Adrian, I have visited that hospital where my brother-in-law as cared for as he was dying from lung cancer. You description is right on. Top notch care with very limited and antiquated resources. Compare that with the heartbreaking stories at http://wearethe99percent.tumblr.com/archive

    I'm glad you are on the mend. Thanks for sharing this story.

    Connie Kuipers

  2. Thanks for sharing Uncle. Have you any sense of what the comparable costs would have been vs. a US hospital?

  3. Hi. I was at this hospital this past week for surgery. I am Canadian. The ladder is still there, the clock is still upside down! Unfortuantely the hospital is now VERY dirty. No running water in washroom sinks, no toilet paper, my room had a broken toilet seat. MD "cleaned" a medical instrument by holding it on a light bulb for 20 seconds and wiping it on his hand before using it on me. My "informed consent" was in spanish.

    The Drs and nurses were very caring and as I am still alive competent.

    The international clinic in Cayo Santa Maria was very clean and the staff there spoke english.

    Just thought your clock note was great - I noticed it as well.

  4. American hospitals are free if you have insurance and if you do not have insurance. They are also the best in the world if you have something serious, like cancer. That why all third world dictators fly to NY or Houston when they are sick.

  5. Thanks for sharing your story. I am delighted to hear that the service was great as a Cuban American citizen myself. I am hoping to do some clinical work in a Cuban hospital after I finish my masters (hoping is the key word) and found your page while doing some mild research. I would appreciate the chance of being trained by such health professionals. It is really incredible how people can still work and provide great results under such conditions. I'm happy your vacation was not completely spent at a hospital! :)

  6. Do you know if they have the needed tools to service a severe allergic reaction for a 15 months old baby? Just in case we have a problem i wanted to inform myself before being there with my son!!!

  7. Sorry, I don't know. Cubans are well trained, but they lack some of the tools and drugs that we take for granted here. I would suggest you take the necessary medication with you.

  8. I spent three days in Cuba hospitals (Veradero and Mantasas) in February of 2009 and my experience was a true horror show. I had a heart attack while in emerg in a hospital in Veradero, and was then transferred (by ambulance - and I use the term loosely) to their heart hospital in Mantasas. No hot water, no light bulbs in any light fixture, no running water, no air conditioning (the unit had been torn from the hole in the wall and the hole stuffed with a pillow). The door from the room into the courtyard was held closed by a plastic water bottle jammed into the frame. There were dogs running i the hallways because the doors were thrown open (no air) and electrical wires were hanging from the ceiling. It was unbelievable! I was finally flown out of Cuba laying on the floor of the galley of our plane and was lucky to have survived the experience. Once back in Canada I was isolated for several weeks (procedure after being in a hospital abroad) and underwent by-pass surgery. Every day I thank God that I survived my experience. The Cuban medical personnel were generally kind, but had nothing to work with. No water (my husband was sent to a corner store to buy drinking water), no computers, no disposable implements, no toilet paper, no soap! As Canadians we take for granted that everyone enjoys the luxury of excellent health care, but I can testify to the fact that Cuba is still a third world country, with third world standards and equipment where you don't want to fall ill.

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  10. I, too, had to go to a hospital in Holguin, Cuba for a dislocated shoulder (second day there! Boo.) The clinic at the resort were unable to help me so I was transferred in an ambulance that had seen better days. The equipment attached to the ceiling of the van was falling down. It was an interesting, stop-and-go (animals and people crossing the roads) hour long ride.
    The ambulance driver was kind.
    When we arrived at the "hospital" which was surrounded by overgrown weeds, we found the doors to the emergency department were locked; chairs were on the tables..nobody was there.
    The ambulance driver went to the front of the hospital, where we, too, eventually entered. There weren't any patients in sight. I did meet two specialists immediately, one was a gastroenterologist, not sure about the other.
    Everything was dim, and it was not very clean looking but I didn't really have a choice. My shoulder was still dislocated.
    I was offered an injection for pain, which I happily accepting (not even knowing what it was!!)
    After they searched for, and found, the x-ray technician, I had an x-ray done.
    Finally, I met the orthopedic surgeon. I was only wearing a bathing suit, and yet, somehow, he gave me dignity by offering me a sheet to cover up.
    The room was extremely hot, so they brought in a standing fan. The doctor applied a chalky substance to my arm, and his hands. He "hired" and fired two assistants who stood behind me to guide my shoulder into place with a towel. One of these assistants was the ambulance driver. The third man on the scene was able to give the doctor the help he needed, and after being urged to "please relax", my shoulder found its home, once again. Immediate relief.
    As for payment, their machine would not accept my credit card, and we did not have enough pesos with us to cover the bill. While waiting to find out what would happen, I was still holding my dripping wet x-rays in front of another standing fan, without a cover, to allow them to dry.
    Finally, the hospital allowed us to go with the understanding that someone would drive one hour the following day to pick up their payment. The ambulance drove us back to the resort.
    The care I received was kind, quick and professional.
    I was left wondering at our own Canadian system which is over-stressed. We are spoiled beyond spoiled with CT scanners, and MRI machines within a short distance. We do not have to pay. I'm not always certain that each and every medical problem that we suffer actually requires a doctors visit. We have too much access and we are not grateful enough.
    I was very thankful to God, and to the Cubans, for the care I received. What could have been a disaster, wasn't.

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  12. Nobody really said what hospital you were at? there are 2.