Dental health is an indicator of quality of life in any country. In Cuba, racked by a perpetual, widespread crisis, it is one of the most affected and most sensitive sectors. Oral medicine and maxillofacial services are among those that have most deteriorated, posing significant hardships on much of the population.
"I've had a get a molar filled for a month, and there's never anything to fill it with. The third time they were able to put a bandage on me because the two times before there were no swabs or sterile material, due to a lack of electricity. Sometimes they bring out the damn swabs early in the morning, but they soon run out, after the first patients, who are almost always friends or relatives of the workers," says Enrique, a desperate Holguin resident.
"The pain I went through was tremendous, because first I had to take antibiotics and there are none for sale. I found them on the street, so I was able to reduce the swelling I had and the pain went away. The doctor herself encouraged me to do that, because there are none," he explained.
"Now they told me to also look for the filling online, and buy it, because this year they haven't received any supplies and, most likely, no more will be arriving. If I don't get it quickly, the infection will come back and I'll probably have to have it removed, and then I'll have to get antibiotics and anesthesia, which are not available either. You can tell that the dentists are very disheartened and we, the people, are suffering. This has never been as devastated as it is now, not even in the 90's."
The deterioration in oral medicine services in Cuba is multifaceted, from the dreadful technical condition of the chairs and working instruments, the lack of them, and of supplies, the educational difficulties entailed by the fact that students cannot practice enough before they graduate, to the exodus of qualified personnel, which has not yet been felt, due to the almost total stoppage of services.
Beatriz, who works in the restaurant sector, assigns great importance to her appearance because she works with the public. "I had a tooth problem with complications, I don’t how, and they started me on a root canal two years ago, and I still haven't been able to get it done, due to a lack of the products and drills they have to use. They just tell me there aren't any, and that's it! They left it open for me about a year ago, and I have a tremendous amount of work to do."
"They can't close it (the hole in the tooth) and they can't finish it either. It's crazy! And, on the street, fillings and anesthesia pop up from time to time, but they don't sell the instruments and products for a root canal. I?m bound to lose that tooth and I'll have to get a prosthesis, also on the street, from private individuals, because that service is also at a standstill," she added.
Yamisleidis, a manicurist, has also suffered a lot, not only from a toothache, but also after visiting an oral medicine clinic. "They still haven't completely solved it, it was just a makeshift solution until there's a filling available," she explained. "I was half an hour sitting in the chair waiting for a drill to appear, which is what they use. I was really upset, with my head lower than my body, because it wasn't working properly and stayed in that position. A disaster."
"The doctor had to bend over to treat me, and every now and then she would stand up, because she had back pain. When the damn drill finally appeared, the ordeal continued, because the equipment was leaking water everywhere. She asked me if I wanted to continue, and I said 'yes,' because I wanted to solve the problem, but I came out of there with my blouse soaked. Nothing works. We're lost in this country," she said with regret.
Javier, a fourth-year Oral Medicine student, told DDC that, "despite the fact that materials for students are given priority, the truth is that most of the time there simply aren't any, and we haven't been able to practice much. We are weak in that area. And there are procedures that, the truth be told, we have never really practiced. We're stuck with theory only."
"There is tremendous disillusionment. Only emergency patients receive care, and there is often not even enough for them. This year, patients have rarely been attended to in shifts. When we started there was a lot of excitement about the missions (abroad), as it looked like the salary had been raised. Now most of the students only talk about leaving, even before they graduate, and the mission, if that should come up," he says.
"No one believes this is going to get any better, or that we have a good future. Many in Oral Medicine have left, and that is nothing compared to those who will leave if given a chance. Before, although the salary was just as bad, one could love the profession. But if there's nothing to work with, not even that sustains us. We can't go on like this."