The Cuban Medical System both Myth and Reality
There are many myths surrounding the Cuban Health Care system, and it is not easy to disentangle the reality from the “overheard”.
There are two health systems in Cuba, and this is the biggest reason for the misunderstanding by many outside of Cuba as to what one can expect if you need medical attention in Cuba.
The first system is for the tourists and officials of the Communist Party. These facilities are excellent and the care is equal to any around the world.
The second, and more prevalent system is the health system for the Cuban people.
This system is lacking in everything. This includes doctors, medicines, proper functioning diagnostic equipment, as well as sheets, towels and toilet paper.
In a series of articles I will be breaking down these problems and attempt to slightly lift the veil of secrecy that surrounds this small island and the myth about its healthcare system.
Let us start with the doctors.
Comparing education systems from one country to another is very difficult. Anyone with a child in a US system will note that it is even hard to do from town to town and school to school, but in Cuba it is especially confusing.
High School is the final level of education for most Cubans. While contrary to the fact that Cuba is touted for its education, higher education is rare.
While Cuba does have an almost 100% literacy rate, the level of reading is not specified. Most people can read the only newspaper printed, Granma, but it is written to about a 5th grade level.
Due to the extreme lack of educators on the island, most teachers in the elementary schools have only just graduated from high school themselves. So the concept of higher education can be very confusing.
Doctors do not, like in the US, attend four years of college and then take grueling entrance exams to then spend another four years of their lives in med school, in Cuba, they leave high school and enter med school.
This is not to demean the quality of doctors that come out of the country; it is just an observation of the educational system. In fact, it is important to note that all Cuban education is free.
There is also a group of doctors, those that serve the first group of health care recipients in Cuba that have spent years training in esteemed institutions across the world. These doctors also are working at some of the most respected laboratories in Cuba at the forefront of cutting edge Cancer research.
Once the doctors that serve the average Cuban citizen go out into practice they can be difficult to find.
All doctors work for the government, there is no private practice, so rural doctors are rare.
One of the reasons for the scarcity of doctors on the island itself is economic.
The Cuban government takes in approximately $8billion a year by exporting their doctors. Presently there are around 37,000 Cuban doctors working in 77 different countries.
The largest amount of these exported Cuban doctors are working in Venezuela. This is a result of a 2003 agreement between the two countries, Doctors for Oil. These doctors work in Venezuela and the Cuban government receives approximately 100,000 barrels of oil a day in exchange. At one time this amounted to about $11,000/month per doctor, although given Venezuela’s present financial crisis the amounts change regularly.
The Cuban doctors, however, are paid an equivalent of $250-$300 per month, a rather large profit for the Cuban government.
In Brazil, from 2013 to 2015, there were over 14,000 foreign doctors in the country most of them were Cuban. The Brazilian government paid the Cuban government $4300 per month for the doctors services. The doctors were paid between $1000 and $1200 per month.
As one Cuban doctor put it “We are the highest qualified slave-labor force in the world.”
The choice to serve overseas is voluntary. However if you do not volunteer you will be labeled “unreliable” and career advancement will stop.
Many doctors serve overseas with the intention of saving money. They also are given the opportunity to send large amounts of consumer goods back to their families with no penalties, a strong reason to spend 2 years abroad.
There is also the knowledge that it can perhaps be an escape route out of an oppressive country.
While living in a foreign country as a Cuban doctor, escape is not that simple. There are always members of the government overseeing the Cubans, watching all that they do and keeping tabs on their whereabouts. But some do leave.
Between 2006 and 2015, 7117 Cuban doctors left their foreign posts and entered the United States. These people are considered deserters by the Cuban government.
They entered the United States under the Cuban Medical Professional Parole (CMPP) Program begun under George Bush in 2006. This policy allows “Cuban medical personnel conscripted to study or work in a third country under the direction of the Cuban government to directly enter the United States from that third country”.
According to the State Department, doctors, nurses, paramedics, physical therapists, lab technicians and sports trainers are examples of groups that may qualify for the CMPP program.
This program allows the Cuban medical personnel to enter the United States as a refugee and be placed on an expedited track for legal residency and eventually U.S. citizenship.
In October of 2015 one such doctor left Venezuela for Bogota, Columbia. On June 23 of 2016 he entered the United States. This doctor “DFC” is now in San Francisco.
I am helping him to navigate the United States refugee system, and will bring you stories as they unfold.
Please come back to read more about the shortages in the medical system of Cuba and follow along with our doctor in the US.
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