US embassy cables: US castigates much-vaunted Cuban health system

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US embassy cables: US castigates much-vaunted Cuban health system

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US embassy cables: US castigates much-vaunted Cuban health system

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* guardian.co.uk, Friday 17 December 2010 21.30 GMT
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Thursday, 31 January 2008, 19:52
C O N F I D E N T I A L SECTION 01 OF 06 HAVANA 000103
SIPDIS
SIPDIS
DEPT FOR WHA/CCA
EO 12958 DECL: 01/25/2018
TAGS PGOV, PINR, PREL, ECON, AMED, SOCI, AMGT, CU
SUBJECT: CUBAN HEALTHCARE: "AQUI NADA ES FACIL"
(HERE NOTHING IS EASY)
REF: HAVANA 0076
Classified By: COM: Michael E. Parmly: For reasons 1.4 b/d

1. (C) SUMMARY: This cable is a follow up to Reftel and provides anecdotal accounts from Cubans about their healthcare, based on USINT FSHP's (Foreign Service Health Practitioner) interactions with them, her unauthorized visits to Cuban hospitals, and her care of USINT American and Cuban personnel. End Summary.

2. (C) The following anecdotes were obtained from Cubans of various walks of life: domestic employees, neighbors in the Havana suburbs, USINT Local Contract National (LCN) employees, service providers such as manicurists, masseuses, hair stylists, chauffeurs, musicians, artists, yoga teachers, tailors, as well as HIV/AIDS and cancer patients, physicians, and foreign medical students.

-- A Cuban woman in her thirties confides, "It's all about who you know. I'm okay because I am healthy and I have 'friends' in the medical field. If I didn't have my connections, and most Cubans do not, it would be horrible." She relates that Cubans are increasingly dissatisfied with their medical care. In addition to the general lack of supplies and medicines, and because so many doctors have been sent abroad, the neighborhood family physicians now care for 300-400 families and are overwhelmed by the workload. (Note: Neighborhood doctors are supposed to provide care for only 120 families. End Note.) In the absence of the physicians, patients go to their municipality's "polyclinic," but long lines before dawn are common, with an all too common 30-second diagnosis of "it's a virus."

-- A 40-year old pregnant Cuban woman had a miscarriage. At the OB-Gyn hospital they used a primitive manual vacuum to aspirate the contents of her womb, without any anesthesia or pain medicine. She was offered no emotional support for her 'loss' and no pain medication or follow up appointments.

-- A 6-year old Cuban boy with osterosarcoma (bone cancer) is admitted to the oncology hospital. Only his parents are permitted to visit, and then only for limited hours. He does not have a television nor any games or toys. The hospital offers no social support services. The parents do not seem informed as to their son's case. When asked by the FSHP what they know about the management of the disease, they shrug their shoulders. According to the FSHP, cancer patients do not receive on-going basic care utilizing testing procedures common in much of the world to monitor cancer care -- such as blood chemistries and tumor markers, sonograms, x-rays, CT and bone scans, MRIs, PET scans, etc. Patients are generally informed of the type of cancer they have, but know little of its staging, tumor size, metastasis, or prognosis. They may be offered surgery followed by chemotherapy and/or radiation but are not given choices to decide an aggressive versus less aggressive approach, nor are they allowed internet access to learn more of their disease.

-- Many young cancer patients reportedly have become infected with Hepatitis C after their surgeries. Contracting Hepatitis C after surgery indicates a lack of proper blood screening prior to administering transfusions. All blood should be screened for Hepatitis B, C, HIV and Syphilis prior to use. Patients have no recourse and are not fully informed of the seriousness of such an inadvertent infection.

-- During chemotherapy and radiation treatments, patients receive little in the way of symptom or side-effects care (i.e., severe nausea, vomiting, low blood counts, fever, diarrhea, radiation burns, mouth sores, peripheral neuropathies,etc.) that is critically important in being able to continue treatments, let alone provide comfort to an already emotionally distraught victim. Cancer patients are not provided with, nor can they find locally, simple medications such as Aspirin, Tylenol, skin lotions, vitamins, etc. Most Cuban patients are not offered Hospice Care or any social support programs for children, adults, or their care providers.

-- HIV positive patients have had the letters 'SIDA' (AIDS)

HAVANA 00000103 002 OF 006

stamped on their national ID cards. Needless to say, in a country where the national ID card must be shown for everything from getting monthly rations to buying a train ticket, the person is stigmatized for life. There is no patient/doctor confidentiality and discrimination is very strong. (Note: According to Pan-American Health Organization (PAHO) officials in Havana, stamping ID cards used to be the case but is no longer the practice in Cuba, something we could not independently corroborate. End Note.)

More:

http://www.guardian.co.uk/world/us-embassy-cables-documents/139530