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It’s been almost two years since I’ve been seen at a hospital. The last time was in that November of beatings and kidnapping when my lower back was in very bad shape. I learned a hard lesson on that occasion: given the choice between the Hippocratic oath and ideological fidelity, many physicians prefer to violate the privacy of their patients–often compared to the secrets of the confessional–rather than to oppose, with the truth, the State that employs them. The examples of this pouring forth on official television in recent months have strengthened my lack of confidence in the Cuban public health system. So I am healing myself with plants that grow on my balcony, I exercise every day to avoid getting sick, and I’ve even bought myself a Vademécum–a Physician’s Desk Reference–should I need to self-prescribe at some point. But despite my “medical revolt,” I haven’t failed to observe and investigate the growing deterioration of this sector.

Among the recent hospital cuts, the most notable have to do with resources for diagnostics. The doctors receive greatly reduced allocations for X-rays, ultrasounds and MRIs which they must distribute among their patients. Anecdotes about fractures that are set without first being X-rayed, or abdominal pains that become complicated because they can’t do a scan, are so common we’re no longer surprised. Such a situation is also vulnerable to patronage, where those who can offer a gift, or surreptitiously pay, obtain better medical care than do others. The cheese given to the nurse and the indispensable hand soap that many offer the dentist noticeably accelerate treatment and complement the undervalued salaries of those medical professionals.

A thermometer is an object long-missing from the shelves of pharmacies operating in local currency, while the hard currency stores have the most modern digital models. Getting a pair of glasses to alleviate near-sightedness can take months through subsidized State channels, or twenty-four hours at Miramar Optical where you pay in convertible pesos. Nor do the bodies who staff the hospitals escape these contrasts: we can consult the most competent neurosurgeon in the entire Caribbean region, but he doesn’t have even an aspirin to give us. These are the chiaroscuros that make us sick, and exhaust patients, their families, and the medical personnel themselves. And that leave us feeling defrauded by a conquest–long brandished before our faces–that has crumbled, and they won’t even let us complain about it.


264 thoughts on “Chiaroscuro

  1. Thank you, Humberto, that was fascinating. It’s amazing that the pro-Castro attack squads attempt to discredit this blog’s author by accusing her of financial success, and by referring to her awards. Don’t they realize that both of those things make her MORE credible, not less? In a free market, crackpot ideas from fringe, lying authors don’t achieve widespread audiences and don’t generate much revenue. If an author sells a lot of books then that means that their ideas have resonated. An author of a New York Times best-seller in non-fiction is inherently more credible than a struggling author who isn’t successful at building an audience. Not the other way around. An award-winning author is more credible than a starving, unknown author. The fact that this Castro propagandist named Roca would spend so much effort trying to discredit this site’s author makes her even more credible.

  2. Miami Web Master, it is not only here but anywhere her writings appear! There is a writer named Angel Roca who has written 12 articles since February of this year, attacking and trying to defame Yoani on Kaos en La Red web site. Below is a link to his list of articles. He and the others trying to defame Yoani there are very transparent and repetitive. Is always the $$ signs and the “mercenary” term thrown about without any proof!

  3. @ #4:

    Damir, your accusation about open source software has no basis in reality. The open-source movement is not opposed to profit. Please read the GPL and some of Richard Stallman’s influential writings on the distinction between free-as-in-free-beer, and free-as-in-liberty. The open source movement is about liberty, not communism. When you confuse the two, it appears to reveal something about your background, tovarich.

    Here in the US, there is currently a technology boom in progress that is largely driven by open source software. The cloud computing revolution that is enabling small tech startups to compete with established players is mostly built on a foundation of open source software like Linux, Git, Ruby, and Ruby on Rails. If you were to attend a professional conference for Rails developers, you would not meet any communists. You would meet a lot of aspiring entrepreneurs who share their techniques with other. You would hear a lot of talk about venture capital. You would see people sharing code for the greater good, while being motivated primarily by the dream of starting a new business and becoming the next Mark Zuckerberg. Both Facebook and Twitter, in fact, make millions of dollars while also contributing to open-source projects like Rails and Cassandra and Mongo DB.

    I have to again ask: what motivates you to constantly search for any new angle to attack this web site and its author?

  4. To me it is cristal chiaro that in the team “yoani’s” heads is all scuro.

  5. “In 2007, Cuba announced that it has undertaken computerizing and creating national networks in Blood Banks, Nephrology and Medical Images. Cuba is the second country in the world with such a product, only preceded by France. Cuba is preparing a Computerized Health Register, Hospital Management System, Primary Health Care, Academic Affairs, Medical Genetic Projects, Neurosciences, and Educational Software. The aim is to maintain quality health service free for the Cuban people, increase exchange among experts and boost research-development projects. An important link in wiring process is to guarantee access to Cuba’s Data Transmission Network and Health Website (INFOMED) to all units and workers of the national health system.”

    Second to only France in the world.

    Despite teh embargo and economic difficulties, Cuba is up there with the two richest countries of Americas, usa and Canada.

  6. Cuban medical care has never recovered from Castro’s takeover, when the country’s health care ranked among the world’s best. He won the support of the Cuban people by promising to replace Batista’s dictatorship with free elections, and to end corruption. Once in power he made himself dictator and instituted Soviet-style Communism. Cubans not only failed to regain their democratic rights, their economy plunged into centrally planned poverty.

    Many treatments we take for granted aren’t available at all, except to the Communist elite or foreigners with dollars. For them, Castro keeps hospitals equipped with the best medicines and technologies available.

    What is it that leads people to value theoretically “free” health care, even when it’s lousy or nonexistent, over a free society that actually delivers health care? You might have to deal with creditors after you go to the emergency room in America, but no one is denied medical care here; even the poorest Americans are getting far better medical services than most Cubans.

  7. Pamela, your post (#236 for now) finally appeared, good work. I enjoyed the movie motorcycle diaries when I saw it, but as you point out and the slate article points out, it is a work of fiction. And I have to put on hold my knowledge of Cuba to avoid the feeling of disgust that so many Cubans must feel when they see this sort of thing. I have met Cuban peasants who remember the communists passing in their trucks and throwing the dead bodies out into the street in front of their wives and children, and laughing as they did it.

    It is true, that he surely held high ideals. As did many of the inquisitors who burned heretics at the stake. To do good in the world takes much more than high ideals, it takes self-honesty and an ability to question dogma or fashionable belief, something that had no place in the philosophies of Che.

  8. Love Cuba
    Junio 8th, 2011 at 23:22

    If You want to guess, go ahed and do it. You don’t need Humberto’s permission.

  9. Humberto,

    I’m curious to know if Barbara Lee was also against the embargo of Apartheid South Africa. Let me guess :)

  10. Humberto Capiro (El Cibergues@)
    Junio 8th, 2011 at 23:06

    Try not to get dog smarter than You are.

  11. Comrade Komar! Boy go to your DOGGIE BED!Enough play for you today! IM BORED OF YOU FOR NOW! I need a SMARTER DOG! OFF TO THE POUND YOU GO TOMORROW!

  12. Humberto Capiro (El Cibergues@)
    Junio 8th, 2011 at 22:51

    See, that is what I don’t get. Dictator is a ONE guy who doesn’t share power with anybody. So how did You come up with TWO dictators at the same time in Cuba.


    YOUTUBE: Rep Barbara Lee On Why Congressional Black Caucus Visited Cuba – and she LIED because she has NOT MET with the opposition!

    S.F. GATE: CA Rep. Barbara Lee on new Oakland-Cuba charter flights: “One step closer” to ending embargo?

    Democratic Rep. Barbara Lee — who’s worked for decades to establish academic and economic ties between the U.S. and Cuba — said Wednesday she’s “cautiously optimistic” that new charter flights from Oakland to Cuba represent “one step in the right direction” toward ending the 51-year U.S-Cuba embargo..
    And, the Oakland Democrat predicted, the newly-announced international charter flights from Oakland International Airport to Cuba will mean jobs, trade — and a much-needed economic boost for the East Bay.

    “Ending the blockade is part of my work,” said Lee in a phone interview Wednesday. She said she’s travelled to and worked on Cuban issues since 1976, and it’s long been clear that “the embargoes didn’t make any sense — for policy reasons, for economic reasons, for trade reasons.”
    “Most important, Americans should have a right to travel anywhere they want to travel,” she said.

    In April 2009, Lee lead a historic mission to Cuba, met with former President Fidel Castro, and pushed for more exchanges of medical and biotech equipment between the two countries.

    Lee said she understands there are still “political realities” to deal with when it comes to ending the embargo between the U.S. and Cuba, but she said recent moves by the Obama Administration to loosen travel restrictions make “a lot of sense” and represent important shifts that can benefit both sides.

    “Oakland is a major international airport airport and it’s increasing its global services,” she said. “We’ll have flights directly into Cuba…and I’m hopeful this may set the stage for even more international flights (out of Oakland) not only to Cuba,” but to the Carribean, China and Asia.

    The latest Oakland-Cuban developments, however, could open up new markets for agricultural products in the Central Valley, for California wine, and other state-produced goods, she said.

    And the new charter flights will bring international visitors to the East Bay, a toursim-boosting move that “will create jobs and economic activity. And every chance I get to bring more jobs to Oakland, I’m going to do that.”

    Lee said with increased academic, scientific and medical exchanges with Cuba, it’s now time for the U.S. to take the next step. She said polls show that “the American people want the embargo ended. We’re talking about a few members of Congress who have their own reasons for trying to maintain it..but it doesn’t make any sense,” she said, especially with younger generations of Cuban-Americans eager to see their ancestral homeland.

    “I do know the president can lift most of the embargo through the executive order…15 or 16 provisions.”

    And lifting the embargo, she said is “the right thing to do.”

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