In Cuba, Health Care Is a Tourist Attraction

Not every tourist in Cuba is looking for Caribbean beaches, daiquiris or romance.

Maria de Lourdes da Rodia came from Brazil for an operation to save her eyes. A kidney transplant brought Raquel Romero, a Chilean, to a hospital room overlooking Havana Harbor.

More than 7,000 foreigners are expected to visit Cuban hospitals and clinics this year, paying a total of $25 million for health care services. While that is only 1% of Cuba’s total income from tourism and a fraction of this country’s $1-billion health care budget, the visits represent exponential growth compared to the few hundred patients who sought treatment in Cuba a decade ago.

Further, the number of these “health tourists” is expected to grow as Cuba develops ways to encourage more such visits.

Cuba wants health tourists for the same reason it sells nickel and invites foreign corporations to build beach hotels: This country desperately needs hard currency.

The collapse of Communist regimes in the Soviet Union and Eastern Europe left Cuba virtually without trading partners, creating an economic crisis in this Marxist nation about 90 miles off the coast of Florida. Cuba, which in addition has no commercial or diplomatic relations with the United States, had to find new ways to pay for its imports.

So, along with other measures, Cuba turned its much-vaunted health care system into an export industry.

Health tourists play a crucial role because their spending goes directly into the health care system. Thus, they help the government keep one of the most important promises of the 1959 revolution: universal health care.

“This nourishes the Cuban health care system,” said Jorge L. Perera, director of Servimed, the government corporation started in 1987 to coordinate services for health tourists. “It permits institutions to obtain the foreign exchange to solve their problems.”

For example, Almeijeira Hospital, which rises above Havana’s sea wall, remodeled two of its 24 floors in 1993 for foreigners such as Romero, a 52-year-old Santiago resident who will have both of her kidneys removed. Two-thirds of the income from those two floors is turned over to the national health care system, said Piedad Almandox, hospital spokeswoman.

*

The remaining one-third buys imported drugs such as anti-rejection medicine for Cuban transplant patients--at a cost of $250 per patient per month. Foreign income also paid for a sophisticated, imported X-ray machine, she said.

“This money allows us to solve problems that we cannot solve with Cuban pesos,” Almandox said.

Through health tourism, this nation exploits an economic advantage as obvious as high-grade ore. Cuba has about 60,000 doctors, or one for every 183 Cubans--more doctors per capita than any country in the Americas.

With the exception of those trained before the revolution, all work for the national health care system, earning about 400 pesos a month--twice the wages of a factory worker but less than $23.

As a result, health care institutions such as Metropolitan Hospital in San Salvador send patients to Cuba “because it is cheap,” said a hospital spokesman in the capital of El Salvador. “A transplant that would cost $20,000 in the [United] States costs $8,000 in Cuba.”

In addition, Cuban doctors have developed treatments--often controversial--and medicine that are available nowhere else in the world.

When Da Rodia noticed that she was losing peripheral vision a few years ago, her Brazilian doctor told her that she should prepare to go blind from an incurable, hereditary disease known as retinitis pigmentosa, which destroys the retina.

“I watched my mother going blind,” said Da Rodia, 56. “She and her sister are both carriers [of the gene that causes the disease]. My grandmother died blind.”

*

Da Rodia was not willing to lose her sight without a fight. “I am a writer,” she said. “I need my eyes.” Watching a television special about Cuba, she learned of a procedure to halt the progress of her disease. Her doctor scoffed at the idea, but she went to Cuba anyway two years ago.

The surgery and three weeks of treatment--including electro-stimulation and vitamin therapy--she underwent then have stopped the disease and have even increased her field of vision slightly, she said. “There have been no changes in my eyes in two years,” she said during a return visit for a two-week follow-up treatment. “Now, my doctor believes in the procedure.”

In fact, he gave her the recommendation she needed so that the Brazilian health care system would cover the $9,500 cost of follow-up treatment. Surgery, which she will not need this time, costs an additional $2,000.

The still-controversial treatment was the first Cuban medical procedure to attract international attention. Demand grew so great that in 1987 a clinic was converted into a hospital for foreigners seeking treatment for retinitis pigmentosa. It remains Cuba’s second most sought-after treatment, following a procedure that eliminates discoloration caused by a skin disease known as vitiligo.

The skin treatment--which has about a 28% success rate--has become so popular that Cuba trained foreign doctors to open clinics in Brazil, Argentina, Mexico, the Dominican Republic and Colombia. Clinics in El Salvador and Uruguay are planned pending government approval of the Cuban drugs used in the treatment.

“This is an opportunity to let people know about medicine that has been developed in Cuba,” said Perera, the health tourism director.

*

Besides exporting medicine, Cubans are also exploring ways to expand health tourism, targeting high-end customers.

The old military school known as La Pradera on the outskirts of Havana has been turned into a four-star hotel--with a hospital inside. Opened Oct. 31, Cuba’s ultimate health tourism facility, near a well-known neurological hospital, offers physical therapy, annual physicals and minor cosmetic treatments such as mud baths. It also boasts a swimming pool with a waterfall, spacious rooms and bungalows--complete with cooks, if desired.

The complex in some ways is reminiscent of a 19th century European health spa. But doctors here are convinced that what they are directing is the future, not the past.

“This is the first facility of its type in the country,” said Dr. Carmen Alvarez, head of the rehabilitation center at La Pradera, “where the patient is also a hotel guest.”

(BEGIN TEXT OF INFOBOX / INFOGRAPHIC)

Health Tourism Growth

Increasingly, foreigners are seeking medical treatment in Cuba. Number of patients:

(please see newspaper for full chart information)

1995: 7,500

* Most requested treatments, 1995

1. Vitiligo (skin disease)

2. Retinitis pigmentosa

3. Neurotransplants

4. Orthopedic

5. Cosmetic surgery

* Patients’ countries of origin, 1995

1. Argentina

2. Ecuador

3. Brazil

4. Spain

5. Venezuela

Source: Servimed