The Double Standard of Healthcare in Cuba

Let the truth be told. Today, Cuba provides excellent, specialised and efficient medical care of the quality that is equal with health services offered in the most of developed countries.

The problem is that foreign patients, who pay in hard currency, can only access this quality of service. Members of the ruling elite in the government and the Communist Party, as well as their relatives, friends, and lovers, plus foreign intellectuals of whatever stream but loyal to the Castroist regime can also enjoy a good healthcare.

In the few health centres where patients have the privilege of being attended by front-line professionals — doctors and nurses — with care, delicacy and good manners, there is no room for ordinary Cubans, those riding Chinese bicycles and ration booklets (existing in our country since 1963) and without friend’s or kin relationship with individuals of the nomenklatura.

For the common Cuban people — about twelve million souls — there is only a health system where everything is scant. Consultations and hospital admissions are done in crumbling, unwholesome and under-resourced facilities. Besides the ruinous conditions of most of the Island’s treatment centres, Cubans suffer the consequences of obsolete medical technology and a chronic shortage of medicines.

Doctors usually have two types of prescriptions. If the patient has few resources, they recommend medications from the poverty-stricken state pharmacy network. In contrast, if the patients’ economic situation is more relaxed, they are sent to pharmacies that trade in strong currencies. In Havana, there are about twenty of these pharmacies, with fully loaded shelves where even medicines with US patents are not in shortage.

From the Cuban capital city, journalist Iván García gives us this testimony:

“In this 21st century Cuba, a person crosses fingers when entering a hospital. First of all, the food is disgusting. You have to bring also everything with you: sheets, towels, cleaning supplies and fans. There are centres where water is scarce, and relatives have to fetch it in buckets so they can clean their sick loved ones.”

Foreign patients, who pay in hard currency, can only access the quality of health service in Cuba.

The correspondent continues:

“Sometimes a person goes into a hospital with a particular symptom and, as a result of the lack of hygiene, the disease worsens. Owing to the exaggerated export of physicians to countries in different continents, the scarcity of specialists in hospitals and clinics is remarkable.”

During the course of the Soviet support that Cuba enjoyed until 1989, its public health system was acceptable and even better than those of other countries in the region. When the constant flow of roubles from Moscow ceased, the national economy fell into crisis due to the usual clumsiness that accompanies Socialism in that area and others. Under these conditions, Cuban healthcare was relegated to the last position in the list of priorities of the Castro regime, and its human resources were derived to the international market.

The former Sierra Maestra’s guerrillas, in power since 1959, now turned into great businessmen, gradually discovered that the export of doctors —in addition to enhancing the regime image— was a commercial activity more profitable than tourism and the nickel industry. Official statistics draw a clear picture of this trade, even considering their low reliability. The Island’s medical staff working abroad provides revenues amounting to over 6 billion US dollars per year to the Cuban government.

These programmes of medical personnel being exported abroad, those are misnamed, as “the internationalist missions” by the Cuban government, do not lack aspirants. The reason for such a “humanitarian” drive is to be found in the wages received abroad, which are well above the 50 USD per month that Cuban health professionals earn on average in our country. Such salaries, however, could be much higher if the Cuban state did not charge the “lion’s share”. The government of Havana keeps about 80% of the remuneration that the specialist receives in the country of destination.

Likewise, the Cuban specialists are motivated by the opportunity of buying items that do not exist or are very expensive in Cuba, as well as acquiring the right to request housing at the end of their contract overseas.

The reason for a “humanitarian” drive among Cuba doctors is the fact the wages abroad are higher than 50 USD per month that Cuban health professionals earn in our country.

The Cuban population —the most neglected link in the medical care chain in our country— could be represented by an average citizen like Zenaida Brito, a 38-year-old woman from Havana, who gives us her opinion with honesty and high-mindedness:

“Nobody opposes our doctors giving services in Haiti or remote African lands, but such programmes should not be made at the expense of the lack of professionals in our hospitals, polyclinics, and dispensaries.”

In summary, only a small group of people in Cuba can be treated in a hospital as if they were in a developed country, and the vast majority of Cubans as if they were in Cuba.



Raúl Rivero is a Cuban journalist, poet, and writer. He is vice president of the press freedom committee of the Inter-American Press Association (IAPA) and collaborates with the most prestigious media in America and Europe.

He has published more than a dozen books of poetry, chronicles, and reports. He was one of the founders of the cultural magazine Caimán Barbudo in 1966. From 1973 to 1976, he was a press correspondent for Prensa Latina in Moscow and later became Director of Science and Culture of this news agency.

In 1991, he signed the “Letter of the Ten Intellectuals” calling for reforms in Cuba, so he began to suffer political persecution. In 1995, he founded the news agency Cubapress, independent from the Cuban regime. In 2001, he co-founded the first independent association of Cuban journalists. In 2003, he was sentenced to twenty years in prison for political reasons. Due to intense international pressure, he was released after a year and a half with his health very deteriorated and went into exile.

Awards: 1969 Prize David and 1972 Julián del Casal National Prize, both granted by Cuba’s National Union of Writers and Artists. 1997 Press Freedom Prize, by Reporters Without Borders (RWB). 1999 Maria Moors Cabot Prize, the oldest international recognition in the field of journalism, awarded by the Columbia University. 2004 Guillermo Cano World Press Freedom Prize, given by the UNESCO


Perth Herald Tribune joined the campaign “My Weekly Denunciation Of the Castro’s Dictatorship”, launched by the UNPACU and the Forum for a United America to raise awareness of the situation of the Cuban people worldwide.


Add Comment