Let me tell you about some of the things that have caught my attention during December as an intern (almost a doctor) in a family clinic in Havana, Cuba.
If this is your first time reading me, I’m in my final year of medical school in Cuba. It’s becoming very challenging because the mismanagement of the country has led the healthcare system to collapse. That’s the reality we face.
The Lock
On the second day at the clinic, we were put to the test.
In "my" clinic, there are three interns. My battle-hardened companion, who loves surgery, a friend focused on neurology, and me, oriented towards clinical care. We’ve formed a good team.
Early in the morning, a woman came in to have some stitches removed from her head. We thought she had been in an accident, but no, she was involved in a domestic dispute with her husband. Several times, her head had hit a lock (we didn’t believe her story because the injuries didn’t match what she said)
According to her, her husband had ended things. It scared me. Still, the stitches had to be removed.
Theoretically, this is the nurse's job, but coincidentally that day, she didn’t bring her glasses, so it was the future surgeon’s turn.
In a normal country, this procedure is trivial, but we’re in Cuba. Here, we play by different rules.
There was no scalpel to cut the thread (which, by the way, wasn’t the right one; the patient told us that the hospital didn’t have any, so they had to improvise).
The light, as you can see in the picture, was far from adequate, but the stitches had to be removed due to the risk of infection.
After gathering the minimal tools for the procedure (don’t ask how), we began. I was lucky enough to be the assistant.
The woman wouldn’t stop moving, talking, and complaining; it didn’t hurt her, but she couldn’t stay quiet.
She talked about everything except how she hit her head against the lock so many times; in the end, she drove us crazy.
When we finished, I couldn’t stop thinking about this image that the "future surgeon" shared with me.
But regardless, we worked hard to help in any way necessary.
Regression
They say times change, and the world moves forward. Cuba doesn’t fit into that.
While I was attending to a patient, they brought me her medical history so I could familiarize myself with it and write about the consultation.
To my surprise, what they brought me was a book.
The doctor explained that these were the old medical records. I was in shock!
To me, they should be the current ones. It’s like having a notebook where you fill in the patient’s information.
Oh no, but since we live in a topsy-turvy world, it’s better for doctors and nurses to be pasting sheet after sheet to form the medical history. Knowing that at any moment, a sheet might come loose, and the information would be lost.
A disaster. That’s why I was so surprised by this method of medical records; it was a convenience. Both the nurse, the student, and anyone could fill it out. Everything was easy to mark.
In conclusion, we have regressed. Not considering that this entire process should be digital by now, but that’s a topic for another post.
Surveys
When we reached our sixth year, we thought we were done with surveys. Every year, we had to do them.
We surveyed for dengue, COVID (throughout the pandemic), again for dengue, or any outbreak that occurred. Honestly, it’s pointless; it’s just self-deception. Still, we complied.
In the sixth year, when we’re supposed to learn therapeutic management, they made us survey again, this time in one of the worst areas of the city. Seriously, instead of attending to patients, we were back on the streets chasing people.
Interestingly, we discovered a peculiar building, perhaps unique in its kind.
The building is called the Pentagon, clearly because of its shape.
I don’t know if it was built before or after the "Revolution", but I had never seen such an innovation in any building.
Be careful if you wear heels. Not to mention how uncomfortable it is to climb.
I suppose once it was built, no one tried to replicate it; just look at the construction to understand why there aren’t more like it.
Which entry surprised you the most? Is there something specific you want to know? Let me know in the comments; I’d be happy to read you.
While writing this post, I had fun recalling those moments; I hope I brought a smile to your face...
December was an extremely busy month; a lot happened, so I had to stop creating content. January seems calm, so here we are. How has the year started for you?
Read you soon!
[dahpilot]
All images are mine
Finally I arrive, I comment you that the post is very interesting because of the situation of "double bind" in which health care in general is in the whole world. In Cuba the state management is totally ineffective, and here the privatization of health and its management with mercantile criteria is degrading patient care day by day. In a large hospital such as the Gregorio Marañón in Madrid, it is not uncommon for there to be no towels or a lack of sheets for admitted patients.
Or with computerization and remote care, absurd things can happen, as happened to my mother. Two months after having her eyes operated on, she was called by telephone to have her eyes checked. It didn't take much to explain the illogicality of the situation to the doctor on the other end of the phone. The situation was resolved with a face-to-face appointment.
I really regret the situation in which you health workers in Cuba work, let's hope that the health care here does not reach such extremes of deterioration, but it seems that there is interest in it.
A big hug @dahpilot.
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It’s always a pleasure to read you, my friend.
Speechless, right now medicine has become a more commercial than humanitarian sector.
The cases of Cuba and Spain are two sides of the same coin. It’s horrifying that such things happen in a European country, like what you mentioned about your mom; it’s illogical, and we could talk all day about it.
Did you know that to practice there I have to wait up to 3 years?
It’s crazy everything we are experiencing. In Cuba, there is no longer a system; this is war medicine and survival. The near horizon doesn’t look very good, at least here
Hi, @dahpilot. What you tell me about the three years I imagined it. In Europe it is increasingly difficult to enter, and one of the ways to do so is not to validate studies. An Ecuadorian friend of mine, a few years ago, had almost none of her medical subjects approved in Ecuador validated. Now, after a decade she is a nurse.
And, regarding the health professions, dehumanization is growing, and I think it is an unstoppable phenomenon... and Cuba, it is very regrettable. I can't tell you much... I see so much talent in Cuba and at the same time the living conditions... It's hard for me to go on, because the world is so unfair.
I have a medical file like that, it has its years... hahaha.
What to tell you, I don't want to ask you with which instrument they got the points...it wouldn't be hard to imagine.You guys need to be given medals.
How sad everything.
the Building I didn't understand!
Please, go ahead, don't let anything disturb your future.
In 6 year I have never saw it files like that , they are vintage 😂
I didn't understand the building either 😂😂 but I leave u this screenshot from MAPS.ME but its something strange , why you put those bar instead and entire floor , why that shape , to many questions and no answer like always here 😂
Mmmmm... interesante, no sabía que teníamos nuestro propio pentágono, aunque esas rejas en el piso me huelen a cárcel....demasiado extraño diría yo ...😂.
Expediente médico ahora mismo no lo encuentro, pero está guardado como un recuerdo de épocas mejores, tenía apenas 15 años cuando me lo hicieron... hace casi 36....¡oye!No es tan viejo....😂
Que tengas una excelente.
Reality trumps fiction. I am speechless.
And this is how we have very talented doctors, who look for solutions and improvise... but this should not be a rule every day.
😣
Every day it really gets harder
In fact, just yesterday, oxygen was being regulated because the factory broke down, so we had to halt operations and regulate the intake of patients—a tough situation.
Even the best can't do anything without the right tools, but in the meantime, we'll make do with whatever we have; the important thing is to heal. But it is unbelievable 😕
That's right... you look like you're in a camp in the middle of a war. Oh, I almost forgot, that building you showed me... that really drove me crazy. Instead of balustrades, railings on the floor... I didn't get it at all.
(No, no hemos visto nada. Siempre hay algo que nos supera)