Wax Off - A Cuban Health Care Story
Travel insurance is for holidaymakers. True backpackers know it’s an unnecessary expense; a shakedown if you will. Throughout my 20s [1] I travelled the globe without the thought of insurance ever occurring to me. Whenever I did encounter a “backpacker” who happened to mention they had insurance I would, quite rightly, scoff at them and abandon the conversation.
Adhering to this professional approach to backpacker life can be tested by countries such as Cuba which, these days at least, has introduced compulsory travel insurance as a prerequisite for entry to the Caribbean isle. It never used to be thus. [2] Castro would allow anyone to turn up on his island, regardless of wealth and ability to pay for any medical expenses.
It was like this back in 2007 when I visited Cuba for the second time. I was living in Colombia in those days and had recently met a young Cuban lady there by the name of Lafonda who invited me to visit the homeland with her. Cuba beckoned and who was I to turn down the advances of this sultry mistress?[3]
Little was I to know, however, that within just a few short weeks I would be incapacitated by a terrible illness - the very kind one hears of occasionally where a person is medivacced out of a third world slum after falling down a cliff or something.
We’d been in Havana for about one week, spending our days discovering the capital on two wheels - Yamaha-branded scooters which, back in those days, were plentiful and easy to rent. The constant riding along the gritty industrial streets of Via Blanca were bearable for the welcoming embrace of the ocean at playas del este in the afternoon, and for the quenching mojitos of Hotel Nacional in the evenings. Only the soot on our faces - with Lafonda sporting an even more comprehensive moustache than normal - retracted from its appeal. The sultry summer nights and daytimes spent submerged in the ocean, no doubt, contributed to my impending ailment.
It was actually while swimming in the Hotel Comodoro pool (having sneaked in) that I first felt a discomfort in my ear. Initially - and for the next 24 hours - I assumed water was trapped in the canal and, thus, all I need do was await the passage of time. As we moved into day two, however, there had been no improvement. My left ear was blocked and causing me all kinds of grief: headaches, imbalance, and a particularly grouchy mood. [4] By day four Lafonda’s mum decided to seek help, which is how I ended up sneaking down back streets of [suburb omitted] in order to be smuggled into the local policlinico, like human contraband.
Cuba’s health care is famously free for its locals. Foreigners, meanwhile, must visit the foreigners only hospitals. The difference is not only price. Similar to how London cleared out the riff-raff in the East End prior to the Olympics, the mirage of Cuba’s mythologised health system shines through in the foreigner-only hospitals, where, although having to pay, the facilities are modern. Johnny America can leave after two-days in a diabetic coma and assume all Cuban hospitals and medical centres are as well equipped. Alternatively, however, Cubans may not have to pay out some pesos for their care, but neither will they have up-to-date equipment, or medicines for that matter. [5] It’s all smoke and mirrors.
“This friend - Carmen - so happened to be an alcoholic. A nurse AND an alcoholic. She was rake thin and had the appearance of 40-cigarette a-day ”
I can’t speak for all policlinicos but this one wasn’t much. Paint flaked off the walls and the tube lights flickered - sometimes because the tube needed changing and sometimes just because of the number of insects trapped inside the plastic cover. We entered through a backdoor, yet we still had to walk through a waiting room where five or six patients (locals) waited to be seen. My mujer on the inside - the one able to smuggle me in - was a nurse friend of Lafonda’s mum. This friend - Carmen - so happened to be an alcoholic. A nurse AND an alcoholic. She was rake thin and had the appearance of 40-cigarette a-day smoker; when she smiled at me, the criss-cross of lines on her face emphasised the tough life she’d had.
Eventually, Carmen guided as all into a treatment room where a doctor eventually appeared. I say doctor. He had the appearance of a baddie who, having whacked a real doctor over the head and dragged the body into a broom cupboard, slips on the white coat of authority and drapes a set of stethoscopes over the neck to add credibility. I could smell the cigar smoke on his breath as he leaned in with the otoscope to examine my troubled ear. At no point did the doctor acknowledge me or attempt to talk to me. He assumed, wrongly, that I wouldn’t speak Spanish. As such, I was treated very much like a dog a veterinary surgery, with Lafonda as my worried owner.
There was lots of tutting and conversing between the doctor and Lafonda. Of course, I understood everything completely, yet Lafonda insisted in interpreting everything anyway, According to the doctor - and much to the amusement of Lafonda and her mum - the cause of my ear pain was a lump of wax the size of a patacón.
The doctor explained that I’d need to drop olive oil into the ear and let the wax soften overnight before they could do anything. Why the doctor didn’t stick to this, I don’t know. No doubt he saw the gritty determination on my face and thought I could take it. Whatever it was, within a few minutes he decided that he fancied a crack at ejecting the wax there and then. So, before I could protest, I was holding a plastic tray under my ear while he injected water into my ear canal like he was fracking for gas.
Lafonda, her mum, and Carmen stood around while my ear was syringed. I have every confidence that, had the issue been more *ahem* personal - say, a problem with another orifice - they’d have still remained in the room while the doctor stuck a finger up my clacker. This is Cuba. Mi casa es tu casa.
After 15 minutes or so of intense discomfort the doctor let out a sigh and I felt a distinct release of pressure form my ear canal.
“Aha,” he cheered, pulling the plastic tray from my weak grasp and showing it around the room like an auction piece.
Judging by the looks on their faces, Lafonda, her mum, and Carmen weren’t prepared on make a bid on this item. The doctor explained something to them which I didn’t fully understand, but which Lafonda took great glee in telling me.
“What?” I said, dazed.
“The doctor said they usually see wax that size come out of 60 year old men.”
Finally the tray was thrust under my eyes and I got to see the ball of tostones-like wax bobbing heavily around in the water-filled tray. I observed it with disdain. To be honest, I was disappointed by its size - judging by the pain I’d been in over the last few days I would have expected something twice as big.
“Bueno,” said the doctor, draining the water from the tray and flipping the wax into a bin. There was some hushed talk between Lafonda’s mum and Carmen.
I knew what this meant. The problem with infiltrating the Cuban health system was that, despite my uncanny ability to say “Que bolá?” in an effortlessly authentic way, the doctor and Carmen saw me only as a foreigner. And foreigners were rich. Oh, and Carmen needed to sustain her drinking habit and so she was relying on me to pay up a little.
I did the old trick of appearing confused and in too ill health to fully understand the she wanted some kind of payment, even though, the way she rubbed her fingers and thumb together, it was clear.
“You have to pay her something,” said Lafonda.
“What does she want?”
“She wants your t-shirt.”
I looked down at my t-shirt, which I’d bought recently. I didn’t have many t-shirts and I looked forward to this one becoming my new favourite for the next five or so years. It had cost me 50,000 Colombian pesos.
“Not this one,” I objected.
“Yes, that one. And your hat. Carmen likes your hat, too.”
The hat was a green baseball cap with a military motif on it. It was my absolute favourite hat.
And so it was, having weighed up the invaluable service that Carmen had done me - I mean, I’d been in considerable discomfort for days and my balance was totally off - that I realised the true worth of what she’d done for me. As we left the clinic I removed my hat and t-shirt, then put the hat back on. What Carmen had done for me was amazing, but let’s face it - she wasn’t the one who’d actually removed the wax from my ear. And the doctor hadn’t hung around for any payment. I folded the t-shirt up and handed it to her, knowing that even if she sold it at half its value she’d be able to buy at least 6 litres of the cheap white rum sold at the petrol station down the road.
While I suffered some soreness in my ear over the next couple of days from all the syringing I barely mentioned it to Lafonda and, within approximately five days, I was as good as gold. Unfortunately, the baseball cap which I’d withheld from my payment to Carmen didn’t fair so well. I leant it to Lafonda one evening and, as is her way, she lost it. I was annoyed to say the least. It’s only now, however, after years of mourning its loss, that it occurs to me Lafonda may have actually given it to Carmen.
[1] The so-called golden era of The Glorified Gypsy, though, to my mind, I’m right bang in the middle of it still.
[2] Or if it always was like this I was blissfully unawares.
3] I refer to Cuba the island, not Lafonda.
[4] Apart from travel and journal writing, one of the things I’m famed for is my amiable mood. My easy going nature. Carlitos de Chilled-Out is how I’m sure Lafonda’s mum referred to me. Alas, this ear problem - such was its indescribable pain - caused some people (namely, Lafonda, Lafonda’s mum, Lafonda’s uncles and Lafonda’s cousins) to consider me as some kind of Anglo Nancy boy. For the record, I’m not. It was a very real pain/discomfort.
[5] In fact, I’m pretty sure I saw one anaesthetist enter an operating room with a bottle of aguardiente and a mouth strop.