Some Cubans choose dose of pri­vate medicine de­spite price ‘He’s the best po­di­a­trist in Havana and all of Cuba’

Kuwait Times - - HEALTH & SCIENCE -

For a dol­lar, Cuban po­di­a­trist Ser­afin Barca will spend a half hour cut­ting the corns off a se­nior cit­i­zen’s foot, or nearly an hour re­mov­ing a stub­born wart. The 80year-old is among the last pri­vate med­i­cal work­ers in com­mu­nist Cuba, which prides it­self on its free, univer­sal state health care and which has barred the cre­ation of new pri­vate med­i­cal prac­tices since 1963 - the year Barca grad­u­ated in his spe­cialty af­ter four years of study.

Barca is busy from morn­ing un­til night treat­ing pa­tients frus­trated with the in­ef­fi­ciency of the state sys­tem. “The ser­vice is of higher qual­ity,” Barca said. “If you get a pa­tient and you don’t treat them well ... you don’t get them back.” Some Cubans believe that al­low­ing more pri­vate prac­tices would im­prove ser­vices and help ease the state’s bur­den, al­low­ing it to con­cen­trate on more com­pli­cated surg­eries and treat­ments that re­quire so­phis­ti­cated tech­nol­ogy. A grow­ing num­ber of Cubans in re­cent years have be­gun to com­plain about the qual­ity of free med­i­cal ser­vices, which many say has been af­fected by doc­tors leav­ing on in­ter­na­tional health mis­sions or mov­ing to coun­tries such as the U.S. in search of higher salaries and a bet­ter qual­ity of life.

Martha Gar­cia, a 72-year-old re­tiree, has been vis­it­ing Barca for her foot prob­lems for more than a decade. “I could go to the Poli­clin­ico, but I don’t get the help I need when I’ve gone be­cause they say they don’t have the nec­es­sary equip­ment,” she said of a free health clinic in Havana. She en­vi­sions pri­vate prac­tices for op­tometrists, phys­io­ther­a­pists and oth­ers. “This would al­low the state to take charge of more com­plex things,” she said. Cuba con­tin­ued to al­low pri­vate med­i­cal prac­tices for the first few years af­ter the 1959 rev­o­lu­tion. But as the coun­try veered to­ward so­cial­ism and the health sys­tem was na­tion­al­ized, about half of Cuba’s doc­tors poured out of the coun­try, leav­ing only about 5,000.

The revo­lu­tion­ary gov­ern­ment poured re­sources into health care, and there are now 70,000 doc­tors - many of whom serve on med­i­cal mis­sions in other coun­tries, which have be­come a sig­nif­i­cant source of in­come for the gov­ern­ment. Only a hand­ful of pri­vate prac­ti­tion­ers re­main be­cause no new ones have been al­lowed in more than half a cen­tury. Pres­i­dent Raul Cas­tro has al­lowed the le­gal pri­va­ti­za­tion of busi­nesses rang­ing from cafe­te­rias to ma­son­ries to hair sa­lons, but pro­fes­sion­als in­clud­ing doc­tors and engi­neers, lawyers and ar­chi­tects have not been given the same op­por­tu­nity. For now, there are no signs state au­thor­i­ties will ex­pand that lib­er­al­iza­tion to the med­i­cal field, con­sid­ered strate­gic by the gov­ern­ment.

Of­fi­cials have tried to raise aware­ness among Cubans about the value of its med­i­cal ser­vices, though. Posters at clin­ics across the is­land tell pa­tients of the costs the gov­ern­ment is pay­ing: a con­sul­ta­tion is $1, an X-ray nearly $4, an MRI $32 and a gall­blad­der surgery $36 - costs dra­mat­i­cally lower than in most na­tions due in part to the low salaries for med­i­cal work­ers, but still sig­nif­i­cant to Cubans, who on av­er­age make the equiv­a­lent of about $20 to $30 a month. Still, a few Cubans pre­fer pay­ing for pri­vate treat­ment. Among them is Mayra Her­nan­dez, a 55-year-old ho­tel worker who said get­ting treated by Barca is worth pay­ing for the bus trip to his of­fice and the fee he charges.

“He’s the best po­di­a­trist in Havana and all of Cuba,” she said, adding that she vis­ited public clin­ics but was un­able to get the treat­ment she needed. She said she’d been 10th in line at one when “the spe­cial­ist came out and said, ‘I have five scalpels and that’s it.’” Barca said he will con­tinue to wel­come pa­tients into his crowded of­fice as his health per­mits. He works four seven-hour days a week. “I like my pro­fes­sion,” he said as he sat in his small of­fice with worn seats and ag­ing fur­ni­ture that seemed frozen in time since the 1950s. “Ev­ery­one who had a pri­vate prac­tice was al­lowed to work un­til they re­tired or died. I’ll be here un­til I die.”—AP

HAVANA, Cuba: Po­di­a­trist Ser­afin Barca at­tends a pa­tient in his clinic.

HAVANA, Cuba: Por­trait of revo­lu­tion­ary hero Ernesto “Che” Gue­vara hangs on the wall next to some med­i­cal books, with a re­flec­tion of po­di­a­trist Ser­afin Barca seen on a glass cabi­net.

HAVANA, Cuba: Po­di­a­trist Ser­afin Barca poses for a photo with a pa­tient in his clinic in Havana, Cuba. —AP photos

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