MIAMI -- In one Cuban hospital, patients had to bring their own light bulbs. In another, the staff used "a primitive manual vacuum" on a woman who had miscarried. In others, Cuban patients pay bribes to obtain better treatment.
Those and other observations by an unidentified nurse assigned to the U.S. diplomatic mission in Havana were included in a dispatch sent by the mission in January 2008 and made public last month by WikiLeaks.
Titled "Cuban healthcare: Aqui Nada es Facil" -- nothing here is easy -- the cable offers a withering assessment by the nurse, officially a Foreign Service Health Practitioner, or FSHP, who already had lived in Cuba for 2 1/2 years.
The Cuban government still boasts of its vast public health system, though the system suffered deeply after Soviet subsidies ended in 1991. It also blames most of the system's problems on the U.S. embargo. Though U.S. medical sales to Cuba are legal, the process can be cumbersome and Havana can sometimes find better prices elsewhere.
The U.S. cable is not an in-depth assessment of Cuba's health system. Rather, it's a string of anecdotes gathered by the FSHP from Cubans 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."
At one OB-GYN hospital, the dispatch reported, the staff "used a primitive manual vacuum to aspirate" the womb of a Cuban woman who had a miscarriage "without any anesthesia or pain medicine. She was offered no ... follow up appointments."
A 6-year old-boy with bone cancer could only be visited at a hospital by his parents for "limited hours," the cable added.
Cancer patients receiving chemotherapy or radiation get "little in the way of symptom or side-effects care ... that is critically important in being able to continue treatments, let alone provide comfort to an already emotionally distraught victim," the dispatch noted.
"Cancer patients are not provided with, nor can they find locally, simple medications such as Aspirin, Tylenol, skin lotions, vitamins, etc.," it added.
HIV-positive Cubans have only one facility, the Instituto Pedro Kouri in Havana, that can provide specialty care and medications, the cable noted. Because of transportation problems and costs, some patients from the provinces may be seen only once per year.
Kouri institute patients can wait months for an appointment, "but can often move ahead in line by offering a gift," the dispatch added. "We are told five Cuban convertible pesos (approximately USD 5.40) can get one an x-ray."
Although the practice was reportedly discontinued, some HIV-positive patients had the letters "SIDA" (AIDS) stamped on their national ID cards, making it hard for them to find good jobs or pursue university studies, according to the cable.
The cable acknowledged that medical institutions reserved for Cuba's ruling elites and foreigners who pay in hard currencies "are hygienically qualified, and have a wide array of diagnostic equipment with a full complement of laboratories, well-stocked pharmacies, and private patient suites with cable television and bathrooms."
Hospitals and clinics used by average Cubans don't come close, the dispatch added, providing details on the FSHP's visits to four Havana hospitals:
At the Hermanos Ameijeiras Hospital, part of which is reserved for foreign patients and was featured in the Michael Moore documentary "Sicko," a "gift" of about $22 to the hospital administrator helps average Cubans obtain better treatment there. The exterior of the Ramon Gonzalez Coro OB-GYN hospital was "dilapidated and crumbling" and its Newborn Intensive Care Unit was "using a very old infant 'Bird' respirator/ventilator -- the model used in the U.S. in the 1970s."
During a visit to the Calixto Garcia Hospital, which serves only Cubans, the U.S. nurse "was struck by the shabbiness of the facility ... and the lack of everything (medical supplies, privacy, professional care staff). To the FSHP it was reminiscent of a scene from some of the poorest countries in the world."
At the Salvador Allende Hospital, the emergency room appeared "very orderly, clean and organized." But the rest of the facility was "in shambles" and guards by the entrance "smelled of alcohol."
"Patients had to bring their own light bulbs if they wanted light in their rooms. The switch plates and knobs had been stolen from most of the rooms so one had to connect bare wires to get electricity," the dispatch reported.
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