|Havana Psychiatric Hospital|
By Patricia Grogg, IPS, January 25, 2011
The trial of staff at the Havana Psychiatric Hospital for the deaths of 26 patients who died of cold and neglect revealed a dark chapter in an institution that was once a shining symbol of Cuba's much lauded health care system, and drew reactions of shock and criticism.
Cuba's main newspaper, Granma, broke the silence Monday surrounding the case, which occurred just over a year ago. The paper reported that prosecutors are seeking prison terms of six to 14 years for an unspecified number of administrators and staff, who were on trial from Jan. 17 to 22.
They were charged with abandonment and neglect of minors, disabled and ill people, and with embezzlement.
The sentences are expected to be handed down in the next few days. The defendants --who were not identified by name -- include the hospital director, the vice directors of the psychiatric, surgical clinic, nursing and administrative areas, and the head nutritionist.
"A trial of this kind is regrettable, especially in the midst of what feels like a historic moment for Cuba, marked by hope as well as concern about the future of the country," parliamentarian Raúl Suárez, who is also a Baptist minister, told IPS.
But he said that what happened in the hospital was "even more regrettable."
The 26 psychiatric hospital patients died during an unusual cold spell in mid-January 2010.
Granma, the mouthpiece of the governing Communist Party, reported that the hospital staff failed to take the necessary measures to keep the patients warm, and did not provide them with adequate nutrition.
A clinical assessment of the patients found "signs of malnutrition and a large number of cases of anemia and vitamin deficiency," despite the fact that the hospital received enough food for 2,458 patients, while only 1,484 beds were occupied at the time.
The report substantiated complaints by family members of patients and neighbours of the psychiatric hospital about staff stealing food and blankets that were sold later on the black market.
"The neglect and irregularities were already problems before, and you wonder how it is that no one saw them," Marta María Céspedes, a retired communicator, told IPS. "Weren't there inspections?"
"I think many ethical and professional principles were violated," said Ubaldo González, a professor at the University of Medical Sciences in Havana, who added that it is a "shame" that this happened in a country like Cuba, which has managed to build such an exemplary health system.
González and Suarez both mentioned Bernabé Ordaz (1921-2006), a physician who fought in the guerrilla forces led by Fidel Castro that overthrew the regime of Fulgencio Batista in 1959, and who headed the hospital for more than four decades. "He transformed that place from a hell on earth to a psychiatric hospital at the level of the best in the world," Suárez said.
González said the hospital's psychiatric and medical services achieved "excellence" thanks to the use of treatments that enriched the lives of the patients, through sport, art, music, singing, and work therapy.
Cuba's health system, the pride and joy of the revolution, provides universal free care. But Céspedes said the crippling recession of the 1990s that followed the collapse of the Soviet Union and the East European socialist bloc had a major impact on the quality of health services.
Like many other people who spoke to IPS, she complained that there are too many Cuban doctors on "solidarity missions" abroad, and too few staffing the country's hospitals and emergency services. "I think this situation should be analysed. The shortage of staff in some services is obvious," she said.
The government of Raúl Castro is currently restructuring the health system with a view to rationalising human and material resources, but without abandoning its extensive international medical assistance programme, which it considers intrinsic to a socialist society and an expression of "proletarian internationalism."
The health budget grew from 10.2 percent of the total state budget in 2004 to 14.2 percent in 2009, and from 5.5 percent of GDP in 2004 to 9.6 percent in 2009, with a growth in staff and in the acquisition of costly technologies.
A total of 600,000 people work in the health system, and 37,000 health professionals from part of medical brigades in 69 countries around the world.
Despite the problems and complaints voiced by some Cubans, this Caribbean island nation's infant mortality rate was 4.5 deaths per 1000 live births -- compared to over 6 in the United States -- and the under-5 mortality rate was 5.9 in late 2010.