Since 2010 64 hospitals have been closed, the country has lost a third of its hospitalization capacity, patients give gifts to doctors and dentists to receive treatment, many surgeries are not performed due to a lack of surgeons, or that necessary to operate; doctors are abandoning their profession to sell crafts, or become drivers; epidemics of all kinds are on the rise, and the lack of medication aggravates or leads to the death of patients...
This is not the start of a story about a country in sub-Saharan Africa, but rather a "medical powerhouse," as Castroism portrayed Cuba to the world, an achievement purportedly resulting from its Marxist-Leninist revolution.
In his 52 years as Cuba's pharaoh, Fidel Castro shouted to the four winds the fallacy that, thanks to the superiority of the socialist socioeconomic model, Cuba had became a juggernaut in contemporary medicine, not only providing Cubans with free service, but also poor countries in the Third World. And he compounded his lying by insisting upon another falsehood: before 1959 medical services on the Island were a disaster.
This myth was so masterfully broadcast throughout the world that even today, 27 years after the system's collapse, UN specialized agencies and millions of people everywhere continue to believe it.
Fidel Castro's boasting of Cuba's free public health and education tandem was his finest political/ideological marketing triumph. As a master of the art of propaganda, the commander employed the classic technique of telling part of the truth, but not the whole truth. There is no better way to lie.
Because it is true that between the 1960s and 1991 public health services in Cuba expanded into rural areas where they had not existed before. But why only until 1991? Because the Soviet Union collapsed, and public health financing along with it. It's that simple.
Castro I's threefold deception
Fidel Castro's deception was threefold: 1) The Revolution was not capable of covering Cuba's massive public health outlays 2) The real aim was not to provide Cubans with health care, but rather to legitimize the dictatorship, relying on outside money 3) His plan was to profit by exporting medical services, not to help poor countries.
Doomed by its aberrational nature, the unproductive Castroist economic system has never generated sufficient resources. Ever. Only the money from Moscow made it possible to come up with the medical window dressing that kept Castro in power. But in December 1991, when Soviet subsidies disappeared, the thoroughly foreign seal on Cuba's medical services was finally revealed: Made in the USSR.
In 31 years of "brotherhood" Cuba received some $115 billion from the Kremlin, which Castro did not invest in nurturing the country's economy, but rather his megalomania. It intervened militarily in several African countries and the Middle East, exported "wars of liberation" and Guevarist terrorism to Latin America, and fancied itself the redeemer of the Third World.
The end of the USSR = the end of Cuba's "achievements"
When "real socialism" collapsed, Cuba sank into an economic crisis that torpedoed the "achievements of the revolution" in the area of public health. For a time Venezuelan subsidies helped to make up for the absence of the USSR, but the Cubanization of el chavismo also destroyed Venezuela, which can no longer prop up the Castroist State, which has always depending on money from others.
It has all gotten worse due to the sending of thousands of doctors and health professionals abroad: more than 33,000 Cuban doctors, a third of the country's 90,161, according to the 2016 Statistical Health Yearbook, work in 62 countries, as "whitecoat slaves." The regime confiscates 75% of their salaries, which comes to some $8 billion dollars per year and constitutes the country's largest source of foreign revenue, along with remittances, and travel and packages from the U.S.
As a result, primary care and its cornerstone, the family doctor and nurse, have almost disappeared, due to a reduction of 23,000 family doctors and nurses, according to official data.
"The revolution of the humble, by the humble and for the humble," as proclaimed by Castro I, far from increasing the number of hospitals and beds, or modernizing them, has ended up closing them; or, now in ruins, they are knocked down to build hotels, which generate income for the military.
The latter is the case of the Pedro Borrás Children's Hospital in Vedado, demolished to build a hotel for the Cubanacán group, one of the Armed Forces' tourism companies. For a long time this outstanding facility, inaugurated in 1934, was the largest and most modern children's hospital in Cuba and in Latin America. Its impressive Art Deco architecture made it a jewel of Cuban architecture and a symbol of the island's medicine.
In the last seven years, 64 hospitals have been closed. The country is rapidly losing hospitalization capacity (32% since 2010), and the number of polyclinics has dropped 9%. Data from economist Carmelo Mesa-Lago indicate that total health staff was slashed 22% between 2008 and 2016. The number of doctors fell 54%, and that of nurses, 16%. In 2010 alone 47,000 employees in the sector were laid off.
All the rural hospitals - strongholds of Castro propaganda - and rural and urban medical stations were closed in 2011. Farmers and their families are referred to regional hospitals, but, due to a lack of transportation, in the event of emergencies their lives are in danger. The maternal mortality rate increased 34% nationally between 2007 and 2015. Costly diagnoses and tests have drastically declined.
There are not enough dentists (there were about 14,000 in 2012, according to the ONEI). There is a shortage of chairs, and a lack of technical personnel, and hygiene. There is no resin to repair teeth, nor materials to make prostheses. On the street one can see young people missing teeth. Many suffer from digestive problems because they cannot chew properly.
Every man for himself
One of the worst scourges today is the dire shortage of medicines and supplies for surgery. Patients have to bring their own sheets, pillows, light bulbs and even mercurochrome to the hospital. There is no water, the walls and floors are dirty, and there are roaches, mosquitoes and foul smells.
Pharmacies lack medicines, even aspirin and other analgesics. According to independent journalists, hypertensive, cardiac and diabetic patients go months without their medications.
The official newspaper Granma acknowledged, on November 29, 2017, that since June the supply and production of medicines has been "seriously affected" because the foreign suppliers that supply raw materials, and the medicines themselves (of which 85% are imported into Cuba) are not being paid.
There are no psychotropic drugs, in a country where depression and stress rates are alarming. Prices on the black market are astronomical, and many who must pay them have no money left over for food, which has spawned more corruption and crisis.
For example, in the line at a pharmacy there is someone who is a friend of a doctor who gave him an unnecessary prescription. He buys the drug, resells it for a profit, and the doctor and fake patient make money. As a result, patients in need cannot get their medications, and get worse, or die.
As someone in Havana said, Cuba suffers from "medical arrogance." This is certainly true of its dictatorial leadership, experts in manufacturing myths. But it is going from bad to worse.