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Weaknesses in Cuba’s health care system

Cuban stamp celebrating achievements in healthcare Cuban stamp celebrating achievements in healthcare Neftali/Shutterstock.com
16 Dec
2014
Cuba has been generous during the recent Ebola outbreak, but the country’s health care system faces major challenges 

Cuba has an almost legendary reputation for providing health care, both at home and abroad. The country boasts an impressive life expectancy at 79.07 years, it’s higher than its arch-rival USA at 78.74 year and almost 20 years better than the neighbouring Caribbean island Haiti, according to figures from the World Health Organisation.

As Geographical has reported, Cuban medical staff have been deployed in impressive numbers to deal with the Ebola outbreak in Africa. The Cuban government has also sent medical staff in large numbers to disaster areas across the world, a considerable achievement for a developing country.

But Cuba’s own health care system faces major challenges. Pay has been cut in the Cuban medical system, and since 2010 a 12 per cent reduction in the health budget has been imposed. In that year, Cuba closed 54 hospitals and reduced overall medical facilities from 13,203 to 12,783, according to the book Cuban Health Care: Utopian Dreams, Fragile Future. In 2012, the Cuban government launched a TV campaign asking ‘Your health care is free, but how much does it cost?’ in a drive to lower health costs.

There are also indications that the country’s more impressive achievements owe a little to manipulating data (or the people). ‘In Cuba, there are instances reported, including by defectors, that if a child only lives a few hours after birth, they’re not counted as a person who ever lived and therefore don’t count against the mortality rate,’ said US senator Marco Rubio in a speech earlier this year. Rubio also alleged that mothers who report a problem with a child before birth are ‘strongly encouraged’ to undergo abortions.

Statistics are also improved by massive immigration from the island. People who leave the country don’t count in the mortality statistics.

The country also struggled with a cholera outbreak between 2012–2013, reporting 700 cases and three deaths. It was the first outbreak on the island since before the 1959 revolution that brought Fidel Castro to power; his brother Raul now rules the island.

A further problem for the health care system comes from a brain drain. The US Cuban Medical Professional Parole Program allows Cuban medical staff posted abroad special dispensation to enter the US. This presents a huge temptation for Cubans sent abroad for health diplomacy, especially as many already have relatives living in the US. The programme has allowed 1,278 Cuban medical staff to defect so far, according to the government-run Radio Havana Cuba.

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