Havana, Cuba – “You’re disgusting – so gross,” Libia Batista Mora told her doctor after he saved her life by sucking fluid filling her lungs out with his mouth.
Mora had a life-threatening bronchial ailment and without proper medical equipment available on the communist island, her doctor – like most medical professionals here – was forced to improvise.
He took a thin piece of plastic hose, deftly inserted it down her throat, and began drawing on the other end.
The practice is common here, perfected after decades-old trade sanctions restricted US-produced medical equipment that would’ve easily handled Mora’s condition without the need for such drastic – and nauseating – measures.
“I couldn’t believe my doctor did that,” Mora told Al Jazeera from her plant-ensconced Havana home where she runs a successful media production business.
“It was so disgusting and I told him that. He said, ‘It was the only way I could save you, so I did what I had to do.'”
Finding a way
Mora’s story of physician ingenuity and self-sacrifice is repeated time and again on this Caribbean island of 11.3 million people.
While the US trade embargo imposed in 1961 has restricted life-saving equipment and medicine, it has only made medical professionals more imaginative in their work – and more determined to provide the best care possible.
Gladys Rodriguez, 80, was also saved by quick-thinking medical staff after heart and kidney failure nearly killed her last year. Rodriguez said she suddenly became dizzy and blacked out, waking up in the hospital days later. Doctors said she needed a special blood coagulating drug, but because of the US embargo, none could be found.
“The doctor told me, ‘We don’t have this medicine, but don’t worry, we’ll find a way to help you,'” Rodriguez recalled.
Her physician kept his promise. He found a generic drug produced by a Cuban pharmaceutical company that was similar to what was needed, though it was missing a key component. Gauging that, he prescribed a heavier-than-normal dose and, fortunately for Rodriguez, his plan worked.
“They did everything they could for me, three to four doctors there always assisting me,” she said of her 19 days of hospitalisation in critical condition.
Asked how much her medical bill cost, she didn’t appear to understand the question.
“Nothing of course,” Rodriguez finally answered.
With attempts at rapprochement with the US under way, Cuba’s renowned universal healthcare system – absolutely free of charge for all citizens – could become a big part of its burgeoning tourism sector.
The difference between Cuban healthcare and the US’ couldn’t be more evident. While American visitors have to pay for Cuban health services, the bill would be a fraction of the cost back home – and many say the care is far superior.
Ileana Gonzalez is a Cuban ophthalmologist with 25 years’ experience. From her modern flat in downtown Havana, she explained in stark terms the difference between US health providers and those in Cuba.
Gonzalez has travelled to the US twice, and on one visit she discovered an elderly family friend with Alzheimer’s disease being treated with 25 different medications – most were unnecessary.
“American doctors are different from those in Cuba,” Gonzalez said. “There, they really don’t care about human suffering and the number one goal of solving patients’ problems. They see medicine as a business first and foremost.
“Cuban doctors, on the other hand, see people suffering and the need to alleviate that. Because of our socialist system, it has nothing to do with profit.”
While most American physicians take home six-figure salaries each year, doctors working in Cuba are paid about $30 per month.
“Our salaries are very low,” Gonzalez told Al Jazeera. “When you study medicine here it’s for love, not money. You become a doctor because you want to help people – that’s all.”
Exporting health workers
Cuba has about 69,000 doctors – 6.7 physicians for every 1,000 citizens, according to the World Bank. More than 20 percent are currently on medical missions in 66 countries.
Since the communist government took power in 1959 after the Cuban revolution, Havana has deployed medical personnel around the globe in an effort to spread its socialist ideals and bolster foreign relations.
Cuba has sent about 185,000 health workers to more than 100 countries since the 1960s. Medical staff have been deployed to some of the world’s worst natural disasters, such as the catastrophic 2004 tsunami in Asia and the deadly earthquake in Pakistan in 2005.
Last year as Ebola ravaged West Africa, Cuba sent hundreds of doctors and nurses to hot zones in Sierra Leone, Liberia, and Guinea – more than any other country.
“They are always the first to arrive and the last to leave,” UN Secretary-General Ban Ki-moon has said of Cuban medical deployments. “They remain in place after the crises. Cuba can be proud of its healthcare system, a model for many countries.”
Cuba’s medical system does have its critics, however. The government makes about $7.6bn annually from countries it deploys its health workers to, and has faced accusations of greatly underpaying those practicing abroad.
Others highlight the staggering fact that physicians working in Cuba make just $30 a month.
Nevertheless, the benefits at home and abroad of Cuban healthcare certainly outweigh the downside.
Dr Antonio Gonzalez Fernandez is the Health Ministry’s director of international relations. He underscored Cuba’s impressive health data, including average life expectancy of 78 years for men and 80 years for women, and an infant mortality rate of just 4.7 deaths per 1,000 births, much lower than the United States.
“We are taught in medical school that the most important thing is the patient and the health of the people, not just Cubans, but people around the world,” said Fernandez, a paediatrician who served two years in Somalia’s port city of Kismayo in the mid-1970s, among other places.
Fernandez said it was Fidel Castro’s vision for Cuba to be a global medical model. “Fidel said, ‘To be an internationalist is to pay our debt to humanity.'”
Mirta Ramos Mejico, 50, is a nurse who has worked in Venezuela and Algeria, and is set to travel to Brazil as a part of Cuba’s Mission Miracle – a programme established in 2004 that has restored vision for 3.5 million people with eye ailments around the world – in some of its poorest areas.
Having just returned from a months-long stint in a remote area of Algeria, Mejico said Cuban health professionals have earned the respect of people around the globe because they are adept at solving medical problems creatively, while providing quality care for free.
“Cuban medical workers are trained to find alternatives, that’s our nature,” Mejico said. “We’re better prepared for the unknown, and we find a way to get it done.”
Mejico told a story of an Algerian woman who had suffered a serious burn around her eye and to half her body after a cooking gas explosion. She had sought treatment for her eye from an Algerian ophthalmologist, but he failed to treat her severe body burns, as that wasn’t his medical specialty.
Mejico discovered the Algerian woman and brought her to the Cuban eye clinic to tend to her other wounds. Despite vast cultural differences they became good friends – a friendship that included salsa dancing lessons, she said.
Asked how it feels to work in one of the most respected medical systems in the world, Mejico’s face lights up.
“It’s the greatest pride I can have. It just makes me feel so proud,” she said.