Yoani Sánchez seemed exhausted when she arrived to give a talk at the Czech embassy in Washington, D.C., on a Tuesday evening in late March. The well-known Cuban blogger and dissident was in the middle of an 80-day, twelve-country tour. (Sánchez was given permission to leave Cuba in February after the Cuban government changed a law requiring an exit visa to travel abroad.)
But it wasn’t the packed schedule and nonstop traveling — or even the heckling she received from pro-Castro demonstrators at several events — that she found most taxing. Rather, she said, it was the need to constantly dispel myths about Cuba, including about its supposedly first-rate healthcare system.
“It tires me to explain to people who celebrate the great Cuban healthcare system how, if we want to visit one of our relatives in the hospital, we have to bring a bag of food under one arm and clean sheets under the other arm to care for the patient because these things are not available in the hospital,” Sánchez said via a translator.
Sánchez, 37, has risen to prominence as a prolific blogger and Tweeter. Sánchez sometimes refers to herself as a “blind blogger,” because the Cuban government blocks her blog, Generación Y, from public Internet sites on the island, which forces her to send her dispatches to friends outside the country, who post them for her.
Sánchez tells the story of everyday life in Cuba. When we interviewed Sánchez in Havana in 2008, she explained that she doesn’t consider herself a journalist but rather “a citizen who is writing about what is happening in my life. I only write about things that I experience personally, whether it is Fidel Castro or the potatoes at the supermarket.” She often vents her frustrations with Castrocare.
The Cuban revolution prompted thousands of doctors to flee Cuba. So Castro made training new ones a priority in his Marxist government.
By some measures, it has done well. Cuba’s doctor-patient ratio is about three times that of the United States. And life expectancy in Cuba, 77 years, is on par with America’s.
Infant mortality is also very low in Cuba. But that’s in large part due to the regime’s promotion of abortion. In fact, Cuba has one of the world’s highest abortion rates, and government officials encourage women carrying babies with disabilities to abort. Infanticide is not uncommon.
But Cuba’s economy is in crisis, and the government’s been forced to shutter many health facilities. In 2011, Cuba closed 465 medical health centers and fired their employees.
Castro has announced that healthcare will soon be a target of budget cuts, and that patients will be charged for some services.
Cuba’s doctors are paid so little that most leave for other countries, a practice the government doesn’t discourage because it can tax their foreign incomes.
Because of mismanagement, there’s not enough medical equipment or essential medicine. Doctors often must re-use some supplies, such as latex gloves, and, as Sanchez mentioned, patients must take their own food, towels, bed sheets and syringes to the hospital with them. Shortages of soap, disinfectants, and sterile equipment are common.
In an in-depth examination of Cuba’s healthcare system, Canada’s National Post found that “Even the most commonly available pharmaceutical items in the U.S., such as Aspirin and rubbing alcohol, are conspicuously absent [in Cuba].… Antibiotics… are in extremely short supply and available only on the black market.”
Cuba’s medical training is not on par with what doctors receive in other countries. According to the Association of American Physicians and Surgeons, more than 75% of Cuban doctors fail in the exam of the Educational Commission for Foreign Medical Graduates for licensing in the U.S.
But the myth of Cuba’s supposedly superior healthcare system lives on in the American media. When Pope Benedict XVI visited Cuba in 2012, MSNBC’s Andrea Mitchell praised the Cuban healthcare system, which she contended was “legendary around the world” and declared that Cubans “really do have universal health care, free.”
But Cubans’ healthcare isn’t free in any meaningful way. “Frequently when we Cubans complain, we point out the inability for us to associate, to access information that we run up against in our lives,” Sánchez said. “There are those who sometimes try to silence us by saying ‘You can’t really complain because after all you live in a country with free health care and education’…Actually, if you get paid only $20 a month for your work you are already paying for your health care and your education.”
In his 2007 documentary Sicko, Michael Moore traveled to Cuba in an effort to prove that Cubans receive better healthcare than Americans. But a Wikileaks dispatch later revealed that Cuban authorities reportedly banned Sicko because it misrepresented the type of care most Cubans actually get. According to U.S. diplomats, the regime didn’t want to risk a popular backlash by showing care that was clearly superior to the care most Cubans receive.
In truth, foreigners and Cuban elites can get excellent private healthcare in Cuba. But such care is beyond the reach of most Cubans.
Sanchez came up with an apt metaphor to explain how many Cubans view their healthcare system. “This metaphor is that of a bird in a cage,” she said. “But where the bird gets food and water, replace that with education and healthcare. Like any caged bird, we still have the desire to break out of that cage, fly through the barn and be free. My view is, fine take away the food and water. But also take away the cage.”
Sánchez is currently in Miami and will soon return to her husband and son in Havana, where she hopes to start an independent online newspaper. She will return to her cage and get back to work until all Cubans are able to fly free.
Photo: Wikimedia Commons

