Dr. Sunset Nogueras Rofes
CIENFUEGOS, June – Cuba, a Third World country that suffers —according to the officials spokespersons— from an economic blocade imposed by the United States, has proclaimed among its accomplishments health indices comparable to those in developed countries and has underlined among
those the high level of control of so-called chronic, non-transmissible diseases. Among these diseases are hypertension, ischemic cardiopathy, bronquial asthma and diabetes mellitus.
In Cuba there is a health program that concentrates on primary medical attention. Its protagonists, family doctors, are obligated to lie in many ways. Primarily at the time of filling out a death certificate.
The death certificate is the official document from which statistics are gathered to indicate the real causes of death in our country, as well as the average life span of its citizens and other data of scientific interest.
We could say that when someone dies at home or at the polyclinic, the family doctor has to write in that document the direct and indirect causes that caused the death of the patient. But this is where the problem starts.
For example, in area 1 in Cienfuegos municipality, some months ago an honest doctor determined the patient’s death was caused by unattended hypertension. Since that determination could be interpreted in the sense that the patient did not control his disease for lack of medicines (as happens
frequently nowadays, a question not accepted by the exclusive providers of medical services in the country: the Communist Party of Cuba) the doctors was summoned, questioned and coerced by the Communist Party, by State Security and by the Area Health Administration, to force him to change the cause
of death. The doctor, facing this pressure, ended up writing "pneumonia" in the death certificate.
Even though the deceased’s relatives are convinced that that was not the real cause of the death of their loved one, even though the "honest" doctor also knows it, that’s the way it was written in the death certificate. The lie survives.
What’s behind all this?
We have to point out that the system of primary care is really effective, especially the program of control of chronic non-transmissible diseases, but, aren’t there deaths in Cuba due to cardiovascular disease, hypertension, diabetes or asthma? Can we say that Cubans don’t die for lack
of control of these diseases? Could it be that medicines that could perfectly well could be manufactured in the country are not available? Or could it be that many of those patients, most of them old, cannot stretch their income to buy the necessary medicines?
Cuba, "the medical power of the Caribbean" according to government spokespersons, will continue to keep a more effective control over its doctors than over its lies. But, the policy of silence will not always be successful: a considerable part of those lies figure in the death
certificates.
Versión original en español
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