Cuba’s Public Health Budget and Rafael

Cuba's Public Health Budget and Rafael
September 4, 2014
By Fernando Ravsberg*

HAVANA TIMES — Rafael Botalin Diaz is 15 years old and suffers from a
high-grade cerebral AVM that could kill him at any moment. It was
detected in April, when he experienced convulsions and blacked out for
half an hour.

He was treated at the Santiago de Cuba Children's Hospital. There, on
determining the seriousness of the case, the Ministry of Public Health
placed him on a plane headed for Havana, accompanied by his parents and
a nurse that was to see him at the Neurology Institute.

Physicians in the capital confirmed the diagnosis and decided that,
given the complexity and gravity of the condition, he could not be
treated in Cuba. The teenager requires multiple embolizations and
radiosurgery, in view of which they recommended sending him to Spain.

Rafael's father explained to me that there is a commission that reviews
each of the cases that must be sent abroad for medical attention. This
commission approved the patient's transfer to a specialized care center
abroad.

All trip and medical expenses are covered by the Cuban Public Health
Ministry. They include anywhere from 30 to 50 thousand euros for medical
attention and the round trip tickets for the child and his mother. She
is also given money for the hotel, food and transportation.

"I have no complaints about the medical attention my son has received,
the problem is that the trip is being delayed and no one is giving me an
explanation," his father, whose name is also Rafael Botalin, tells me.

He explains to me that, after his first meeting with the official
responsible for these types of cases, he has never again been able to
see anyone. He adds that the few times he has managed to get this person
on the phone, he has received a very curt reply: "we have no new
information for you."

Rafael has requested a meeting with the Vice-Minister for Public Health
several times to get an answer, but he has never been able to get past
the secretaries, who always tell him their superior is on vacation, at a
meeting or simply away.

He said that, finally, one of the secretaries took pity on him and
informed him, over the phone, that the true cause of the delay is that
the year's budget for sending patients abroad has run out and that he
would have to wait until January of 2015.

Rafael again consulted with the doctors, who reiterated that the case is
very serious and should be treated as soon as possible. The problem is
that the malformation is very complex and is aggravated by the changes a
person experiences during adolescence.

They explained to him that another episode like the one he suffered in
April could cause permanent damage and even death. Getting no answers
from the Ministry of Public Health, the father is writing dozens of
letters – to UNICEF, the WHO and the Central Committee of the Communist
Party, among others – but no one replies.

Finally, he wrote my blog, Cartas desde Cuba ("Letters from Cuba"), in
an attempt to make the case public, believing that he is facing mere
bureaucratic hurdles, unwilling to have his son's life depend on that.
"If the budget's run out, then they should get the money from less
important health programs," he said to me.

"Cuba invests money to help couples who suffer infertility and I think
that's very good, but they can't prioritize that over the life of
children who have already been born," he added, arguing with as much
passion as reason.

Without a doubt, Cuba's economic resources are limited and sending
patients abroad to receive medical attention at the expense of the
Public Health Ministry is commendable for a Third World country.

It is advisable for the different sectors of the economy to restrict
their spending to a given budget, but there are some sectors, such as
health and education, in which flexibility is of the essence, in order
to avoid having a child die of a curable disease or be left without a
teacher.
—–
(*) Visit the blog of Fernando Ravsberg.

Source: Cuba's Public Health Budget and Rafael - Havana Times.org -
http://www.havanatimes.org/?p=105952