Cuba's health system struggles with shortages, broken equipment and staff losses

Cuba's once-prized public health system is under severe strain from power cuts, medicine shortages, ageing equipment and the loss of medical workers, according to patients and medical staff interviewed by AFP.

Rosa Valentina Perez, 64, has spent nearly three weeks in Cuba's main cancer clinic waiting for a CT scan after losing mobility in her legs. She had breast cancer surgery two years ago and needs the scan to find out whether the cancer has reached her spine. The report says the only working CT scanner in Havana is at the city's neurology hospital, where the waiting list is long.

Cuba built a health system that offered free care and was presented by the communist government as one of the main achievements of the revolution. AFP reports that the system is now close to breaking point after the Covid pandemic, tighter US sanctions and an energy crisis worsened by what it describes as US President Donald Trump's six-month-old fuel blockade.

Hospitals are dealing with long power outages, shortages of medicines and supplies, equipment failures and an exodus of doctors, nurses and technicians to better-paid work abroad or in the private sector. The government has focused limited resources on priority areas including cancer, cardiology, nephrology and maternal and child health, but staff in those departments say they are also under heavy pressure.

At the National Institute of Oncology and Radiobiology, the waiting list for radiotherapy is above 1,200 patients. Institute director Luis Eduardo Martin told AFP that 80 percent of the equipment used for diagnosis and treatment is obsolete or broken. He said doctors sometimes give medicines without being able to fully check whether they are working because they lack reagents or monitoring equipment.

Children remain a priority for treatment, but the report says they are also being affected. Government data cited by AFP says Cuba's childhood cancer survival rate has dropped from 85 percent before the crisis to 65 percent now. Mariuska Forteza, who heads the institute's pediatric oncology unit, said routine blood tests are being reduced because of shortages of equipment and fuel to move samples between hospitals.

Technicians continue to repair equipment where possible. Alexis Amado Dominguez, a repair technician, said he sometimes goes to the hospital at midnight or 2 a.m. to fix machines so patients can start cancer treatment.

Heart care has also been reduced. Jose Esteban Abreu, a doctor at the National Institute of Cardiology and Cardiovascular Surgery, said the number of heart operations performed each year has fallen from more than 400 in 2018 to barely 100 now. Around 130 patients are waiting for pacemakers. In the hospital's maintenance area, equipment awaiting repair includes anesthesia machines, cardiopulmonary bypass machines and heart monitors, with some machines taken apart for spare parts.

In a workshop that repairs most of Havana's medical equipment, broken incubators and neonatal ventilators are accumulating. Staff shortages are making the equipment crisis harder to manage.

At the dialysis unit of Havana's Hermanos Ameijeiras Hospital, nephrology chief Iamara Castro told AFP that some dialysis sessions have been shortened from four hours to two hours so more patients can receive treatment and to avoid overworking the remaining staff. She said shortening hemodialysis shortens life, but that the service is being kept going by compassion and effort from staff.

Nelson Companioni, an 81-year-old dialysis patient, said he often worries equipment will fail before his session ends and has watched nurses try to get a small pump working again.