Cuba is facing a complex and deepening health crisis, fueled by a confluence of economic hardship, widespread shortages of essential resources, and a surge in mosquito-borne viruses. The island nation, long recognized for its advances in healthcare, is now grappling with a system strained to the breaking point, as detailed in recent reports from El País and The Wall Street Journal. This situation underscores the critical link between economic stability and public health, and highlights the disproportionate impact of systemic challenges on vulnerable populations.
Cuba is facing a growing health crisis fueled by widespread shortages of food, medicine, and electricity, compounded by the spread of multiple mosquito-borne viruses. The situation highlights the interconnectedness of economic stability and public health, demonstrating how vulnerable populations can be disproportionately affected by systemic challenges.
A surge in cases of dengue, chikungunya, and oropouche – collectively referred to by some Cubans as “the virus” – is causing widespread illness across the island. Symptoms include high fever, skin rashes, vomiting, diarrhea, and headaches. In severe cases, patients are experiencing significant swelling in their hands and knees, leading to difficulty walking and, in some instances, complete loss of mobility.
“If someone is limping, it’s very likely they had the virus. If they’re dragging their legs, they had the virus. If they’re complaining about their joints, they were also sick,” according to a report in El País.
Cuba has been grappling with an ongoing economic crisis for several years, exacerbated by factors including economic restrictions, inflation, medicine shortages, and a growing exodus of healthcare workers. These challenges have placed immense strain on the country’s healthcare system and negatively impacted the health and well-being of its citizens.
The situation is expected to worsen, according to The Wall Street Journal, as the United States increases pressure on Venezuela, Cuba’s primary economic benefactor. Approximately 70% of Venezuela’s crude oil exports, crucial for Cuba’s energy supply, are now at risk due to a partial blockade of sanctioned tankers.
Government officials and the World Health Organization/Pan American Health Organization (WHO/PAHO) have confirmed that the illnesses circulating in Cuba are caused by the simultaneous spread of three arboviruses – dengue, chikungunya, and oropouche – transmitted by mosquitoes. The presence of additional respiratory viruses, including COVID-19, is also contributing to the strain on the healthcare system.
As of early November, Cuba’s Ministry of Public Health (MINSAP) reported 5,717 new cases of chikungunya, bringing the total number of cases to 38,938. Dengue fever remains active in all 14 provinces and 113 municipalities across the country.
Health authorities have acknowledged at least 47 deaths attributed to these arboviruses, though experts and activists believe the actual number is significantly higher due to underreporting and potential misattribution of cause of death. This discrepancy underscores the challenges in accurately assessing the full impact of the health crisis.
Sources speaking with BBC Mundo report knowing of several recent deaths linked to the “virus.”
Infant mortality rates have also risen sharply, increasing by 85% from 4 per 1,000 live births in 2018 – the lowest level ever recorded in the country – to an estimated 7.4 per 1,000, according to the United Nations. This increase is a concerning indicator of the broader deterioration of healthcare access and quality.
The Ministry of Public Health reported a 71% increase in new chikungunya cases in just one week, while PAHO reported a total of 25,995 cases of the disease. However, many individuals are hesitant to seek medical care unless their symptoms are severe, leading to an underestimation of the true number of infections.
“There are many babies a month old who have died, also between 2 and 4 years old, as well as many young people, because vomiting and diarrhea dehydrate them, they arrive at the hospital already collapsed,” an anonymous worker at the Institute of Hematology and Immunology in El Vedado told El País.
A recent report from the Pan American Health Organization (PAHO) notes that “amidst dengue and oropouche epidemics throughout the country, the risk of outbreaks of transmissible diseases remains high due to prolonged flooding, lack of access to potable water, and poor hygiene in temporary shelters for evacuated populations. This situation also increases the probability of outbreaks of digestive, respiratory, and other vector-borne diseases.”
“While the health system has been able to maintain certain health services and epidemiological surveillance with existing resources and trained personnel, there is a shortage of reagents and laboratory supplies for diagnosis, antibiotics and other medications for treatment, as well as basic supplies for the functioning of health services,” PAHO reported.
“City of Zombies”
“Matanzas today seems like a city of zombies… that’s how we are, bent over, in pain. Just go out into the street and look,” journalist Yirmara Torres Hernández wrote in a social media post that was widely shared. Reports from the island describe patients with fever, stooped posture, and difficulty moving as a result of the epidemic, according to BBC Mundo.
El País recounts the story of an 81-year-old woman who began feeling unwell in October and was becoming increasingly hunched over. Her family took her to the hospital, and the doctor diagnosed her with chikungunya based on her physical condition. A week later, her diabetes and blood pressure became unstable, and she experienced tachycardia. “We took her to the doctor twice, they checked her vital signs and that was it,” her son, Alexander Hernández, said.
Days later, doctors told them everything was under control and she could return home. She passed away on November 5. Hernández requested an autopsy, but the doctor refused. “She said no, and I didn’t insist because there was no transportation, she practically convinced me it was pointless,” he told the newspaper. His mother’s death certificate lists “natural causes.”
In Cuban hospitals, Silvia – who spoke with BBC Mundo – says, “there are no conditions to accommodate patients. Everything is overwhelmed, including the pediatric units. There is no proper diagnosis; they only provide hydration, acetaminophen, and paracetamol for joint pain.”
“The truth is, things are very precarious. People are simply dealing with it at home as best they can, practically unable to walk due to the pain,” she added.
A 50-year-old professor from Havana says, anonymously, that “most” people do not go to medical centers after becoming ill.
“Almost everyone I know doesn’t go. People choose not to go because there’s no way to get a reliable diagnosis in those institutions, and there are no medications. You have to buy them on the black market, or have a family member or friend send them from abroad, or someone who lives here give them to you,” he says.
The worsening economic crisis has left Cuba’s healthcare system in extremely precarious conditions. Public health experts say that Cuba’s previous mosquito control and fumigation programs have failed due to shortages of fuel, insecticides, and funding.
Most hospitals are severely lacking in equipment, supplies, and medications, preventing them from providing even the most basic medical and hygienic conditions for patient care. El País reports that many people are self-medicating with herbal remedies due to the absence of pharmaceuticals in a country where 70% of needed medicines are unavailable – more than 460 drugs are currently not available in state pharmacies and health centers.
Even basic items like syringes, gauze, and antibiotics are increasingly difficult to obtain, while obsolete machines break down due to a lack of spare parts.
“The biggest concern for Cubans today is the lack of reagents in healthcare institutions that can accurately confirm what type of virus they have,” the Spanish newspaper notes.
Adding to the crisis, thousands of Cuban doctors have emigrated abroad in recent years, leaving services overwhelmed, shifts uncovered, and chronic overwork for the remaining staff, who earn around $30 per month at the real exchange rate.
More than 2.7 million people – approximately a quarter of the island’s population, many of them young and ambitious – have fled the island since 2020, with hundreds of thousands going to the United States, according to estimates from Juan Carlos Albizu-Campos, a demographer based in Havana.
“What Cuba is experiencing – a phenomenon I call demographic emptying – is nothing less than a humanitarian disaster seen only in countries at war,” he said.
Almost 90% of the Cuban population lives in extreme poverty, and 70% do not eat at least once a day, according to the Social Rights Observatory, a research center that conducted a month of surveys last summer. More than 78% of Cubans say they intend to leave the island, driven by concerns about food shortages and frequent power outages that can last 18 hours or more in some regions.
