Monday, October 29, 2007

Dental pain

Juventud Rebelde published an article yesterday on the problems of dentistry in Cuba based on an investigation by a team of reporters who visited clinics in six provinces across the island.

The article is here, and a Reuters report in English is here.

The majority of the clinics visited had shortages of personnel, and the reporters also found clinics that lacked equipment, materials, and even running water.

One dentist said she sometimes relies on patients who have cars to go to the warehouse to get the supplies she needs, and she sometimes takes it upon herself to distribute supplies to clinics in her municipality.

The reporters also found patients who resorted to “private clinics” where they paid for services. The top dentistry official in the Ministry of Public Health, interviewed by the reporters, admitted that this practice occurs, and he said that eight dentists had been fired in the past two years for it.

The official also concurred with the reporters’ findings that Cuba’s dentists – there is one dentist for every 1,049 Cubans, the article says – are not evenly distributed, leaving some areas under-served. He said that when thousands of dental personnel now in training begin to practice their profession, the Cuban public will be better served and Cuba will be able to “maintain cooperation with other nations” – an indirect admission that shortages are caused at least in part by dentists serving abroad.

The article is similar to a series that appeared a year ago in Juventud Rebelde, documenting problems in state enterprises.

13 comments:

Anonymous said...

Michael Moore will be devastated.

leftside said...

Phil loves posting these stories that both please and worry both sides of the debate.

Folks like anon (enough of all the anonymous postings) see it as evidence that Cuba's services are of poor quality. Folks like me will point to the larger picture, nearly buried in the Reuters piece, that Cuba's dental outcomes still rate as high as "western" countries.

I believe it is wrong to link the dental problems cited in the article to the internationalist programs. The problems are shortages of materials and poor organization. We also have to credit the editors of JR and some of the other Cuban media. The bottom line is that these dental services are free, that the effects of the special period and embargo are still rippling, and that with very little, Cubans do a hell of a lot (and better than anyone else in the region).

Ubre Blanca's Ghost said...

I am the ghost of Ubre Blanca, condemned to graze undead until properly buried! MOOOOOOOOOOO!

Phil Peters said...

Lefty, I see what you mean but if you can believe it, I put the article there because I thought it was interesting.

I don't think there's any doubt that the deployment of so many doctors on missions abroad has strained the domestic health care system. Cuban doctors will tell you that with some family doctors gone, they have been replaced in their consultorios by medical students (residents) in their final year before graduation; there are cases where the territories of two family doctors have been combined; and in some policlinicos it's hard for a smaller number of doctors to cover all the shifts. In the article, that official's reference to the dentists deployed abroad was oblique, but it's pretty clear what he meant, and with newly graduated dentists coming, he's saying help is on the way.

leftside said...

I wasn't trying to throw stones, because I agree these types of stories are often the most interesting. But it was a pattern I thought I would remark on. I, for one, would like to see more stuff coming out Cuba itself, especially during this critical time...

Look, I am sure there is an effect that could be characterized as negative when 20,000 doctors and dentists are serving abroad. But I think most would agree (and the article argues) the biggest problems in the health department is not lack of qualified staffing. Cuban facilities were way overstaffed for so long, that folks got used to a certain way. I'm sure it has changed a bit, but not to the point where you are going to see health or dental indicators fall. And of course, the doctors and dentists abroad bring in a lot of money, which helps with the larger material shortages. So I think that issue is a red herring, designed to discredit what is a fantasicly beneficial program to all involved.

Anonymous said...

Phil,
ah poor Leftside! He cannot believe his paradigm of a socialist government could screw up even if JR says it in its front page. My,my, what a twisted picture one can see when one looks through socialist red color glasses.
Although you never believe anything anyone who disputes your idea of what life in Cuba is, my wife just came back from the island and she just happens to have close relatives who are in the medical profession. The disaster is so great that the personnel who serves on the medical staffs themselves even though they work at the hospitals, have to wait up to 3 or 4 months to have a scheduled appointment with a doctor, specially if said doctor is a specialist physician in any branch of medicine. The same goes for the dentists on the island.
You see, is much more profitable for the Cuban regime to have these doctors in Venezuela earning the regime upwards of 10,000 dollars in hard currency (while paying them peanuts in salary) per month while the average Cuban waits months for an appointment to see a doctor. But please don't tell Leftside this (he does not believes it anyway)there might be a remote chance he will remove those socialist red colored glasses and see the truth that stares him in the face.

leftside said...

I have no illusions about this issue. As I said, of course it is more profitable to have doctors earning market-level salaries abroad than to have them providing health care for free in Cuba. The question is whether the internationalist programs are good for Cuba and secondly, good for the world. I don't think there is any doubt what the answer is on both counts. Have appointments become harder to get? I don't doubt it. Are some Cubans grumbling? I am sure they are. But I also have no doubt that the vast majority of Cubans, at the same time, understand the program and recognize its overall worth to the Cuban people. They understand it because they are well informed and know their leaders are honest and the money is going to help them in the end.

Your beef seems to be that "the regime" is pocketing the money, which is a neat trick to deny the central fact that the dollars are being plown back into Cuban public services. But I suppose if you believe the Castro's are stealing all this money, then there is no convincing you.

Rafael said...

Mr. Leftside, please, whatever you say, please don't pretend to know what average Cubans are thinking. They have enough problems with everyday struggles to survive without foreign fellow travelers trying to suggest to the outside world that they are happy in their awful condition.

leftside said...

Mr. Rafael, I try to be precise with my words. Please do not muddle them by twisting my point about ONE program that I have had conversations with Cubans about into something larger. People in the US speak (wrongly, mostly) for the Cuban people all the time - here and elsewhere. If you want to argue something, stick to what I actually said...

Anonymous said...

Leftside knows nothing about Marxism and the lack thereof in Cuba's state capitalist system.

He also has never lived in Cuba; he has never witnessed the level of corruption (called "socio-lismo") where in order to get decent health care in Cuba you must pay off the doctors and nurses. And that includes the dental sector.

He deems the Cuban people unworthy of basic rights; he is a hypocritical "burgu├ęs" that likes to "slum it" with the Other.

Go back to your loft and your organic veggies and forays to Trader Joe's.

leftside said...

Once again, someone called anonomous goes off topic when the argument is lost and begins the personal attacks...

John Conrad said...

So they're socialist. That means we have to stay just shy of all-out war with them? What a bunch haters running this country. Why should we feel threatened because they want to have free dentists? Is it the dentists and doctors in this country not wanting people to find out that such a thing is possible? Here the government pays for the majority of the cost of educating them, then they have to be treated like Gods for the rest of their lives. Maybe we should pay ALL the cost of their schooling and then treat them like the glorified plumbers they are.

Tony Destroni said...

sad to hear this things i hope the government will do their responsibilities on clinics . more dentistas
and aides to make sure the health of their people .