Jose Angel Portal Miranda, Cuba’s Minister of Public Health, described 2023 as one of the most difficult years for the healthcare system. The minister publicly acknowledged the systemic crisis in the sector and called for the revitalization of healthcare in the country.

“There are deficiencies in the organization of services, as well as in the management of key processes for primary and secondary care. This generates dissatisfaction,” stated Portal Miranda. He added that the quality of service at health institutions is low. He announced that shortages of supplies will continue, leading to “constantly rearranging activities.”

The Exodus

Portal stated that the migration of health personnel both abroad and to other sectors of the national economy was a reality. He urged addressing issues affecting the quality of teaching “and [having an impact] on the training of future professionals, which inevitably [affected] the quality of services.”

Public Health officials acknowledged in October 2023 the exodus of over 8,000 undergraduate students, more than 5,000 postgraduate students, and over 1,400 faculty members from medical schools. 

The decline of the Cuban healthcare system has only worsened. In 2022, there were 46,000 fewer workers compared to the previous year, according to data from the Statistical Yearbook on Health and Social Assistance. The breakdown of the figures indicates that between 2021 and 2022, Cuba lost more than 12,000 doctors, 7,414 nurses, and over 3,000 dentists.

The most probable causes of abandonment include migration to other countries, low salaries, a shortage of basic supplies, rumors of a possible prohibition for healthcare workers to travel, and increased work hours due to unfilled vacancies.

Lisset Castaigne, a pediatric intensivist, is an example of professionals seeking work in a different area than healthcare. “I am passionate about a child’s smile, but I cannot save lives when my salary is not enough to buy food or anything basic; not to mention that you work miracles with almost nothing,” she explained to El Toque.

Although the Ministry of Public Health took measures to alleviate the situation caused by the lack of professionals (authorizing moonlighting and payment for overtime), recent statements by the minister of health confirm that the downward trend in healthcare personnel has continued in recent months.

Shortages and Abandonment

Between 2010 and 2022, 63 hospitals, 37 family doctor’s offices, 187 maternity homes, and 45 dentistry clinics closed, according to data from the National Statistics and Information Office.

Likewise, most of the 13,454 healthcare units in the country show signs of neglect. Patient testimonies report inefficient electrical and air conditioning systems, walls with mold and leaks, overcrowded rooms, poor nutrition, the presence of insects (cockroaches, bedbugs, and mosquitoes), inadequate ventilation, a shortage of drinking water, and a lack of ambulances.

In mid-2023, Ailuj Casanova Barreto, Head of the Department of Primary Health Care, reported that 1,626 doctor’s offices did not receive running water; of these, only 65 had resolved the situation. She also explained that 3,314 family care centers were in a regular or poor state of construction.

The shortage of resources, equipment, supplies, and medicines is acknowledged by Portal as a cause of population dissatisfaction. He warned that it will continue in 2024 and has led to citizen complaints and protests in recent months, along with several requests for humanitarian visas.

In late November 2023, the protest of several mothers in front of the Ministry of Public Health in Havana came to light. Holding their children’s medical records, the women demanded a better quality of life and a humanitarian visa for them to be treated abroad.

The most recent case of a violation of the right to health in Cuba is that of Amanda Lemus Ortiz. The 2-year-old girl has been waiting for a liver transplant for over 12 months, which her father is willing to donate. However, according to activists and family members, the “William Soler” Pediatric Hospital lacks the necessary resources to perform the operation and refuses to use supplies that her family can provide.

The Cuban government is trying to alleviate the current shortage of medical supplies through donations from abroad. On January 28, 2024, the “William Soler” Pediatric Hospital and the Institute of Gastroenterology received donations from the organizations Puentes de Amor and Code Pink. During 2023, the healthcare system in Santiago de Cuba received 96 donations — ambulances and neonatology equipment — arranged with the support of solidarity groups from Spain. International organizations (World Health Organization, Pan American Health Organization, United Nations Development Program, and UNICEF) who have also made recent donations to the Cuban healthcare system.

This article was translated into English from the original in Spanish.