The Center recently decided to broaden its activities to provide services to foreign patients willing to pay in US dollars. However, this hospital is incapable of offering services different from, or better than, treatment people could receive in their own countries. Foreign patients are obliged to share their facilities with military personnel, since the hospital functions in many ways as a military installation. Hospital authorities work closely with unscrupulous recruiters abroad who funnel patients to it via misleading information. The services offered to foreign patients are inefficient. This is particularly the case in the intensive care unit.
……………………..Refusing to accept these conditions, I was relieved of my position. I subsequently resigned from the Center, the Communist Party, the Cuban Federation of Women and the National Assembly. My unexpected departure forced the government to ask Vice Minister Alvarez to keep his bureaucratic position and take over direction of the Center. (That's why Dr. Alvarez, a gastroenterologist now directs a hospital dedicated to the neurosciences.)
After my resignation, the authorities harassed me and attempted to discredit me both personally and professionally. They followed all my movements for at least two months, and during this entire period, an occupied automobile was always parked outside my house. They tapped my telephone (I also received various anonymous phone threats) and they intercepted and opened all my personal correspondence. My staff was intimidated and prohibited from speaking with me, and all areas of my work were scrutinized in an unsuccessful attempt to find some pretext for censuring my qualifications.
Their campaign against me was also aimed outside Cuba. All my communication with colleagues abroad was blocked. The authorities discredited my scientific reputation and tried to send other specialists in my place to the medical congresses to which I was invited, though foreign scientists refused to accept the replacements. The government went so far as to try to "expropriate" my foreign professional friendships. They tried to "buy" many of the specialists with whom I had established professional relations. This tactic met with limited success.
IN HOSPITALS THAT TREAT BOTH CUBANS AND FOREIGNERS, THERE IS AN ENORMOUS DISPARITY IN THE QUALITY OF HEALTHCARE SERVICES.
My family was also affected, When my son and his wife prepared to visit Japan, both were detained at the airport and were subject to a brutal assault and incredible harassment. They had obtained all the necessary travel documentation, but it appeared that they would be forbidden to travel. Though they managed to leave two hours later, I sent an energetic letter of protest to the authorities, demanding an explanation. Their reply referred to my scientific and professional merits, and begged apologies, alleging that "there had been a regrettable confusion in the course of a sweep intended to capture someone who was traveling on a false passport."
Since I was removed as Director of the Center, Cuban patients have been given treatment inferior to that given to foreign patients. The hospital facility is now limited to foreign patients who can pay in US dollars, leaders and bureaucrats of the regime and their friends and family.
Everyone else is required to be treated in an annex that lacks many basic facilities. The Cuban victims of Parkinson's disease are not guaranteed the scarce and expensive drugs they need, and the practice of prescribing unnecessary Cuban drugs continues.
The quality of the Center's staff has diminished. There has been a proliferation of acts of robbery, corruption and illegal diversion of funds. Hospital workers are clandestinely promoting and selling medicine to patients. (The drugs in question could be adulterated or fake.) Continuing scientific and professional staff education has been replaced by unproductive, demagogic political assemblies, since far greater emphasis is now placed on the Center's role in propagandizing the supposed virtues of the regime. The Center has lost complete contact with the international scientific community, largely because specialists in other countries refuse to work with an institution so heavily politicized and so sloppy in its professional discipline.
The Center advertises and performs restoration surgery, yet the specialist assigned to this work is a generalist and possesses neither the proper qualifications nor the necessary training. Soon the Center will carry out functional surgery on patients suffering from Parkinson's disease, a form of treatment which has not been adequately studied. These operations will also be carried out by young, unqualified physicians. Many of the professionals charged with rehabilitating patients have been trained in education or sports and thus lack the proper background to deal with neurological patients. The wavering attention to hygiene in the preparation of food in the hospital has frequently resulted in cases of gastroenteritis and enterocolitis. Obscure practices have invaded the institution --even in the presence of patients, procedures of santería and witchcraft are practiced.
Since February of 1994, the negative practices I outlined earlier have become standard in all Cuban hospitals that sell medical services to foreign patients. The main objective of many Cuban hospitals is generating foreign cur currency, by any means necessary. International relationships are driven by business logic and the need to make a profit. Acting as intermediaries, unscrupulous foreigners promote Cuba's services and recruit patients, many of whom are subject to deception or fraud. For example, through an association with the Italian businessman Guiseppe Dell'Osso, drugs past their expiration dates are promoted and sold at excessively high prices. Quite frequently, unnecessary surgical procedures are recommended just to generate more income. The operations are carried out by young physicians who lack the necessary experience or knowledge to perform them successfully.
Why have I taken the trouble to write down all these terrible situations? Because I hope it will convey the unscrupulous nature of the Cuban authorities regarding the provision of medical services as an income source. I hope that it illustrates how those same authorities are capable of destroying work that benefited thousands of sick people, and attacking individuals who have committed no crime, save to defend ethical and moral values and to refuse to bend to government pressure. I am not moved by any personal interest, much less by a desire for revenge. But I do consider it my obligation as a physician to defend both ethics and truth. Let those who read these pages do with the information what they consider best.
Dr. Hilda Molina, a former member the Cuban National Assembly, is one of Cuba's most distinguished scientists. She broke with the government on the issue of medical apartheid, the denial of medical care or medicine to Cubans while the same services are provided to dollar-paying foreign patients. In this report, smuggled out of the island, she says that she "opposed the use of Cuban patients as laboratory animals." Dr. Molina is founder of Havana's International Center for Neurological Restoration. She is a virtual hostage on the island, and despite repeated requests, she and her elderly mother have not been permitted to travel abroad.***
Health Care in Cuba: Myth Versus Reality*** According to these doctors, "we . . . can categorically and authoritatively state that our people's poor health care situation results from a dysfunctional and inhumane economic and political system, exacerbated by the regime to divert scarce resources to meet the needs of the regime's elite and foreign patients who bring hard currency."
Referring to the growing disparity between health care provided to ordinary Cubans and that offered to tourists and high ranking Communist party members, the exiled Cuban doctors noted that they "wish that any one of us could provide tours to foreign visitors of the hospitals Cira Garcia, Frank Pais, CIMEQ, and Hermanos Ameijeiras, in order to point out the medicines and equipment, even the bedsheets and blankets, reserved for regime elites or dollar-bearing foreigners, to the detriment of our people, who must bring their own bedsheets, to say nothing of the availability of medicines."***