In Cuba, Where Public Health Is Prized But Doctors Pay The Price
Universal health care in Cuba has led to one of the lowest infant morality rates in the world. But as doctors flee to work abroad, the ones remaining complain of difficult working conditions.
HAVANA —Sheila González walks under a scalding sun, surrounded by dilapidated buildings. Seven months pregnant, the mother-to-be lives in a poor downtown neighborhood in the Cuban capital.
As she carries her lunch, González is a walking symbol of the Cuban health care system, which, along with education, is the greatest achievement of the guerrillas who came to power in 1959.
In a country that boasts one of the lowest infant mortality rates on the continent, taking care of a pregnant 27-year-old single parent and human resources technician is a priority.
“My gynecologist and the family’s physician are very demanding,” González says. “They pay attention to everything. My weight, the baby’s weight, my blood pressure. I know my son is in good hands, before and after his birth.” She was below the ideal weight at the beginning of her pregnancy and started a state program that reinforces a good diet, with a daily lunch.
“I like my country. I don't say bad things about the government. I say what I think should be improved,” she says, adding that the food supplied for pregnant women is not enough. “My mother had two girls in better conditions than mine,” González says.
When the birthrate in Cuba drops, and when people migrate to other countries, the population is obviously affected. In other words, if medical care is available and universal, the health care system isn’t exempt from the lack of resources stemming from economic crisis.
In many places, the infrastructure doesn’t differ from downtown Havana’s ramshackle buildings. Physicians do not publicly complain, but they send letters to the government describing their working conditions — low salaries and the unpaid overtime. On top of that, physicians have been leaving Cuba at a higher rate over the past 10 years, which adds pressure to the system.
“Many good doctors have left,” González says. “Many of them only think about money.”
On the other side of the city, 56-year-old teacher Alina Guerra says that there has always been enough physicians, but she only went back to the doctor’s office when hers returned from Venezuela.
One pediatrician who doesn’t wish to be named thinks that physicians fleeing for Brazil — two of them are her colleagues — will mean that she’ll have to work twice as hard.
Cubans jokingly ask, “What are you going to do in Venezuela?” or “Are you going on a mission?” Then someone else answers: “No, I'm going to see my doctor.”
According to researcher Julie Feinsilver, author of studies about health care in Cuba, it’s not possible to establish whether there truly are too few doctors or whether it’s just a matter of perception.
In her opinion, the health care system helps to make the government legitimate. “The Cuban population's health is a metaphor for the health of the political body,” of the nation, Feinsilver says.