The Doctors' Lament

The Doctors' Lament
Posted on April 7, 2013
By Julio Cesar Alvarez | Havana | From Diario de Cuba.

Demands by doctors to receive remuneration for hospital shifts were not
accepted by the Government when it was developing the draft Guidelines
for the Economic and Social Policy of the Party.

The response the doctors received from the authorities was in the nature
of an order and command that the healthcare union has not dared to
question: "Assessing these criteria, it is determined that hospital
shifts are an activity inseparable from the exercise of medical practice
and an essential principle in the training of all health professionals,
for which there should not be an additional payment. "

According to the Government leadership, "The conditions for applying a
general increase in wages still do not exist."

However, after the refusal, the Government decided to authorize a
controversial payment for night work for doctors and dentists, and to
extend it to nurses and other workers in the system.

Let them eat cake. Thus, the government has applied to some doctors a
new provision authorizing the payment of two Cuban pesos (8 cents U.S.)
per hour for night shifts.

In many cases the response is resignation before the fear of reprisals
for publicly questioning a government decision, or the impossibility of
Cuban workers going on strike to force the government to give way before
their just demands.

In others, and although no one is willing to come out publicly, the
decision is considered a mockery and a hypocrisy on the part of the
government, especially considering the high salaries and pensions paid
to military personnel. Many of those wages far exceed what any
healthcare professional receives, even without considering the
"gratuities" — the other tangible benefits — given to everyone in
uniform, and especially to those of higher rank.

"'There's no money to augment the salaries,' is a hypocritical
statement. How can there not be the conditions to increase the salaries
of doctors for hospital shift duty, if every member of the armed forces
(FAR) and the Ministry of the Interior (MININT) earns more than we do?"
complained one of the doctors who was asked for an opinion and who
requested anonymity.

"You can see any of those nobodies of the Armed Forces riding around all
day in the new Chinese cars they give them. It seems that the air
conditioning and the tinted windows make them forget that what Cuban has
is an excess of heat and a lack of public transport. I know colleagues
of mine — surgeons — who don't even have their own apartment. They have
to live with their in-laws. To get to work, they use the old tactic of
putting their white coats over their arms and standing at the stoplights
so someone will give them a ride to the hospital. Nevertheless, any
child of the Government leaders, without earning it in any way or having
any kind of training, travels in a modern car paid for with the people's
money."

Two kinds of doctors

"In Cuba doctors are highly appreciated by the people. It's paradoxical,
but it is precisely the people, the great majority of whom have nothing,
who sometimes take the little they have to give it to the doctors at the
hospitals or the clinics where family doctors practice. One patient
brings a banana, another some sweet, or a soft drink or a packet of
coffee. My clinic sometimes looks like a farmers market," says Carlos, a
doctor who claims to be a revolutionary but is one hundred percent in
agreement with his colleagues' complaints about the amount of money paid
for hospital shifts, which is barely a pittance.

On the other hand, Paulino, an ophthalmologist who served on a foreign
mission with his wife, in a country where they doctors are allowed to
receive donations for patients, isn't very interested in the issue of
payment for hospital shifts, at least for now.

After serving more than five years on the foreign mission, his wife was
given the opportunity to buy an apartment, and the government gave him
permission to buy a car. He bought a Hyundai. That mission opened two
doors that remain closed even for many doctors: a roof and
transportation. In that sense healthcare personnel believe there are two
castes of doctors in Cuba: those serving on foreign missions (that is,
traveling to get money), and those who do not travel.

And following simple logic, many wonder how it is possible that you can
not compensate physicians for working the hospital shifts, when it is
precisely the services of Cuban doctors to other countries, along with
other exports of human capital trained on the island, that bring into
the country the Government's primary source of foreign exchange*.

*Translator's note: Cuban doctors and other personnel working on
"missions" earn considerably more than doctors working in the country,
but are only paid a tiny portion of what foreign governments, such as
that of Venezuela, pay the Cuban government for their services; the
national treasury pockets the remainder.

Translated from DiariodeCuba.com

5 April 2013"

http://translatingcuba.com/the-doctors-lament-julio-cesar-alvarez-diario-de-cuba/