Cuba - Lonely Planet [395]
Return to beginning of chapter
IN CUBA
AVAILABILITY & COST OF HEALTH CARE
The Cuban government has established a for-profit health system for foreigners called Servimed ( 7-24-01-41), which is entirely separate from the free, not-for-profit system that takes care of Cuban citizens. There are more than 40 Servimed health centers across the island, offering primary care as well as a variety of specialty and high-tech services. If you’re staying in a hotel, the usual way to access the system is to ask the manager for a physician referral. Servimed centers accept walk-ins. While Cuban hospitals provide some free emergency treatment for foreigners, this should only be used when there is no other option. Remember that in Cuba medical resources are scarce and the local populace should be given priority in free healthcare facilities.
Almost all doctors and hospitals expect payment in cash, regardless of whether you have travel health insurance or not. If you develop a life-threatening medical problem, you’ll probably want to be evacuated to a country with state-of-the-art medical care. Since this may cost tens of thousands of dollars, be sure you have insurance to cover this before you depart. Click here for details.
There are special pharmacies for foreigners also run by the Servimed system, but all Cuban pharmacies are notoriously short on supplies, including pharmaceuticals. Be sure to bring along adequate quantities of all medications you might need, both prescription and over-the-counter. Also, be sure to bring along a fully stocked medical kit.
Return to beginning of chapter
INFECTIOUS DISEASES
Dengue (Break-bone) Fever
Dengue fever is a viral and mosquito-borne infection found throughout the Caribbean. A major outbreak of dengue fever, centering on Havana and resulting in more than 3000 cases, was reported from November 2001 through to March 2002. Since then, an aggressive government program has all but eradicated dengue from the island. See also Click here for information on avoiding mosquito bites.
Hepatitis A
Hepatitis A is the second most common travel-related infection (after traveler’s diarrhea). It occurs throughout the Caribbean, particularly on the northern islands. Hepatitis A is a viral infection of the liver that is usually acquired by ingestion of contaminated water, food or ice, though it may also be acquired by direct contact with infected persons. The illness occurs throughout the world, but the incidence is higher in developing nations. Symptoms may include fever, malaise, jaundice, nausea, vomiting and abdominal pain. Most cases resolve without complications, though hepatitis A occasionally causes severe liver damage. There is no treatment.
The vaccine for hepatitis A is extremely safe and highly effective. If you get a booster six to 12 months after the first vaccine, it lasts for at least 10 years. You really should get this vaccine before you go to Cuba or any other developing nation. Because the safety of the hepatitis A vaccine has not been established for pregnant women or children under the age of two, they should instead be given a gamma globulin injection.
Hepatitis B
Like hepatitis A, hepatitis B is a liver infection that occurs worldwide but is more common in developing nations. Unlike hepatitis A, the disease is usually acquired by sexual contact or by exposure to infected blood, generally through blood transfusions or contaminated needles. The vaccine is recommended only for long-term travelers (on the road for more than six months) who expect to live in rural areas or have close physical contact with the local population. Additionally, the vaccine is recommended for anyone who anticipates sexual contact with the local inhabitants or a possible need for medical, dental or other treatments while abroad, especially if a need for transfusions or injections is expected.
The hepatitis B vaccine is safe and highly effective. However, a total of three injections