The doctor, who preferred to remain anonymous, for fear of reprisals, told DIARIO DE CUBA that Manuel Marrero's words against health personnel prompted his complaint because the authorities "are now looking people to blame for the dreadful conditions to which the patients are subjected, deprived of vital and necessary medicines and supplies in the struggle against this terrible global health crisis."
"We were deeply offended by the statements by the Prime Minister, Manuel Marrero, who claimed that there had been more complaints about malpractice by doctors than about shortages of medicines. I believe that his statement, apart from being inappropriate and out of touch with reality, seeks to release the Cuban State from responsibilities incumbent upon it," he said.
"The current context allowed me to muster the courage to condemn what the authorities are trying to cover up through their continued propaganda portraying Cuba as an "international medical powerhouse". Year after year we have been asked to believe that with less we can do more, which is impossible under any circumstances, especially when it comes to health, where there should be no room for improvisation."
"The hospitals are overwhelmed. Patients have to wait for hours to be treated, they are not getting rapid diagnostic tests, and they are currently being sent to Covid-positive patients' homes because the polyclinics are not logistically capable of guaranteeing attentive, quality service. Essential drugs (antibiotics, antipyretics to reduce fever, analgesics, and oxygen) are lacking. The situation is chaotic from an administrative point of view. Under such circumstances the only way to wash your hands of it is to blame the staff, which has been overwhelmed ever since the pandemic began. They haven't rested," he said.
"My colleagues and I don't have a moment of rest. We're working 24 hours a day, threatened with the prospect of a patient dying at home and being held responsible, from a medical/legal point of view, for malpractice. Patients call us late at night to complain about the shortages and the absence of medical transport (factors beyond the scope of our work and our control). We cannot say that our workday ends at 5:00 PM, and we have to make a great effort to show our dedication when what we want the most is that our space, which has been violated with threats, be respected," he said.
According to the doctor, the directors also threaten that they will bar from "international missions anyone whose opinions or interests are not in accordance with the Revolution. In this country the unions do not protect workers and do not provide guarantees or defend rights, despite our complaints. Very few have made their complaints manifest, which have not been properly reviewed. Everyone fears retaliation in response to constructive criticism," he said.
A "humanly impossible" task
The doctor from Pinar del Río said that ever since the pandemic began they have had to "visit Covid-19 positive patients without basic means of protection, such as gloves, gowns, masks, and caps," and "check in patients in the health area when the polyclinics lack the requisite drugs." Every day they are obliged to "look for suspicious cases in the community. If no suspicious cases are found during the investigation, we are forced to attend a meeting with the director after 5:00 PM, at which we are admonished, even threatened at times."
"In my case there are 30 daily consultations … in addition to compliance with the care programs for the elderly, the Maternal and Child Care Program (PAMI), where pregnant and lactating women attend consultations, the Vaccination Program, and the HIV-AIDS Program, among others. Added to all this is epidemiological surveillance and the detection of positive and suspected cases of the disease. It is a humanly impossible task, and we are forced to commit fraud on the sheets on which we are supposed to report that we have done all this, just to maintain the figures for the annual statistical yearbook, which has always been a lie, and Cuba sells it to the world as a great feat of the healthcare system," he said.
The doctor described as "absurd" the number of patients they are obliged to vaccinate daily in places that do not feature the necessary conditions or sufficient personnel. "The numbers vary between polyclinics, but in my office they asked for 150 patients in an eight-hour workday. To request such large numbers of vaccinated patients one must have basic conditions: water, electricity, personnel to disinfect the space, nearby sinks. "
"We were forced to attend meetings at the most critical time of the pandemic. At one of them a doctor was positive for Covid-19, and there were more than 60 doctors gathered there, and the appropriate epidemiological tasks, such as isolation and PCRs, were not even carried out. In this case, only the head of the basic group isolated herself. The rest of us had to continue working without knowing whether we were positive, and that is dangerous, because we work with pregnant women, children, the elderly and debilitated patients," he explained.
The doctor said that health personnel "are prohibited from going to buy basic necessities and food during working hours, though everyone knows that stores are closed after 5:00 PM, and to be able to buy a product you have to wait in long lines because, due to shortages, there is no way to buy them anywhere else."
"When we are in contact with a positive patient, we are not monitored or tested unless we present symptoms, and even in this case we must continue working. We have been fined 2,000 to 3,000 pesos for absurd things at our workplace, such as lowering our face masks to eat in an open space, for dirty foot sanitation mats, knowing that it is ridiculous to fine us for this when all we ever had was a makeshift one, a quilt, which they didn't even give us," he said in reference to the demand to keep the entrance to the polyclinic clean.
"We are forced to have extensive files on those positive for the disease when at the polyclinic, since the pandemic began, they have never given us the necessary sheets or pens. And yet, we are told that we have to 'figure it out' because if the files are not done we'll be sanctioned. And we've been forced to lie during ministerial visits and tell them that everything is fine," the doctor concluded.