Cuba is a country that intrigues many. Few nations with such a small population, 11 million, have so many historical events, people and symbols recognisable far and wide.
The trade embargo, the Cuban missile crisis, Ernesto ‘Che’ Guevara (admittedly Argentinian but made famous in the Caribbean nation), the classic cars; everybody knows or recognises a little about Cuba. I travelled there to investigate another issue that defines the country for many, its health service.
It’s something that creeps into the Irish discourse too. TD Finian McGrath has stood up in the Dail and said Ireland could learn a lot about how to administer an effective health service from Cuba. One of Ireland’s most respected surgeons, Dr David Hickey (now retired), has been a consistent advocate of Cuba’s preventative healthcare model.
The Caribbean state is an outlier in health. By economic measurements, it’s a developing country. By health statistics in life expectancy, child mortality and HIV/Aids rates, it competes with many developed countries in Europe and North America. The reasons as to why have brought me to Cuba.
One immediately obvious aspect is the imprint of health within the society. At the time of the revolution, one of Havana’s biggest buildings – then partially under construction with plans for it to become a bank – was repurposed into a 23-story hospital in the centre of Havana. The hospital Ameijeiras stands out clearly in the capital’s skyline.
The airport has advertisements throughout saying “Cuba: Un destino para salud” (Cuba: A health destination). One whole district of the capital is made of of bio-pharmaceutical companies invested in by the state to counter the inability to buy drugs because of the trade embargo imposed by the United States.
The billboards on the side of the road aren’t given to big advertising giants like Coca Cola, but serve as propaganda. Many focus on health proclaiming “Salud para todos” (Health for everyone) with photos of Cuban medics travelling on a mission to Angola in the early-1960s. The types of missions that Cuban doctors have done and continue to do throughout the world.
Health remains the pride of the revolution. One interview I was conducting was interrupted by a man walking by who overheard the topic. He promptly lifted up his top showcasing three separate scars on his belly and abdomen. “Three operations, all successful and I never paid one penny for them thanks to the revolution”.
Not only that but health is big business for Cuba. Under an Oil-for-Doctors agreement with Venezuela for example, Cuba sends 30,000 doctors per year to Venezuela. In exchange, it gets petroleum.
With that comes pressure though. It’s in the interests of the state to safeguard its pride and joy; the legacy of bringing free healthcare to all Cubans across the state, rich and poor.
Criticism of Cuba’s health service is a sensitive subject. One local when told I was here to report on health gave me a shocked look and responded “Oh! That’s complicated. Good luck with that”.
You do get the sense that locals feel they know better than criticise the revolution overtly. A foreign journalist coming in reporting on a sensitive topic is met with a grimace. In one day, three different doctors cancelled planned interviews with me. “We have to continue living in this country. I hope you understand”, was one of the excuses.
“Don’t expect things in journalism to work like they do in your home country”, a local photographer told me early in my trip. He was right.
Journalist Fergal Browne was funded under the summer 2015 round to travel to Cuba to report on Cuba’s health diplomacy.