This blog's title means "Cuban-hearted woman" (very loosely translated!). I settled on this name because it had a nice ring to my unschooled ear and, more importantly, because I think the Cuban people seem to have so much
heart, and they're in my heart for that reason. In general, the people I've met in Cuba are quite consistently open-hearted and big-hearted in the way they relate to each other or to visitors in their beautiful land. A piece of my heart now resides in Cuba, with the warm, wonderful friends I've made there. This blog is not intended to be a guide to Cuba, just a forum for my eclectic bits of writing – poetry, opinion pieces and information gleaned from my personal experience and reading.

Sunday, September 26, 2010

In Cuba: Toilet seats? No. Medical insurance? Yes.

Every time I've been planning a trip beyond the bounds of Canada, to anywhere but the 'Untied States of Amerryca' that is, I've been asked if I'm going to get shots. I've always declined to do so. Now, in planning another trek to Marea del Portillo and Pilon, Cuba, I will still pass.

It's not that I'm vaccinophobic or that I like to live dangerously; I just don't feel it's necessary. Cuba has an outstanding record regarding medical care. In fact, one is more at risk from whatever nasty germs us foreigners bring in with us that what is locally grown. If I were going to a larger resort or a more transiently populated place, I might have myself inoculated against hepatitis and such things. However, where I like to go, to laid-back, low-key little Club Amigo Marea del Portillo in the relatively rural region of Granma, I'm not too likely to encounter health-related problems beyond a lack of toilet seats.

[ASIDE: After puzzling about the conspicuous absence of comfortable seating in many a loo, I finally asked a Cuban friend, as politely as I could, "So, what's the deal with toilet seats? Are they too expensive to replace or just hard to get?" He explained that it was both - they are a pricey luxury and, because some of the porcelain fixtures are American classics and other are neo-Russian, the seat styles are not interchangeable and, therefore, it's not easy to find the right kind.]

Lest you think I'm some wild child, throwing caution to the wind when it comes to protecting myself in a foreign land, let me quote from the Havana Times website:

"There is no need to get vaccinations, such as hepatitis or tetanus, etc. when coming to Cuba. Not only are these and other vaccinations NOT recommended, but Cuba is one of the healthiest countries in the world!

"For instance, it is one of the few countries in this part of the hemisphere that has managed to control dengue – an acute infectious disease, occurring in tropical and sub-tropical areas, transmitted by the Aedes aegypti mosquito and characterized by fever, headache, extreme pain in the joints and muscles, and skin rash – to such an extent that its anti-dengue program has been recognized by the United Nations as one of the most efficient in the world.

"If you require any kind of emergency medical care or hospitalization while in Cuba, rest assured that the quality and level of care will be on a par with what you can expect in most countries. Throughout the country, there is a network of hospitals staffed with highly qualified medical personnel and state-of-the-art equipment.

"And, if you are in a rural area when a health problem strikes, you will immediately receive professional attention from local health personnel, be they family doctors at local clinics, until more specialized assistance is available. In fact, many visitors to Cuba have glowing stories about the quality of health care they’ve received when a medical problem has occurred during their visit.

"If you take prescription drugs, bring the amount you’ll need for the time you plan to stay in Cuba. If you use tampons, bring what you’ll need; although they do exist here, they’re not always readily available."

Being shot, so to speak, is an option, but it is really a matter of personal preference, not a requirement. Beyond that, though, it is now vital that you have medical insurance when entering Cuba. As of May 2010, legislation was implemented stating that: "For entry into the country, all travelers, foreigners and Cuban overseas residents are required to possess a travel insurance policy, covering medical expenses, issued by an insurance entity recognized in Cuba."

However, in the government's typically inscrutable fashion, there has been no specification as to what qualifies as a recognizable "insurance entity," as far as I know. Some people have said that a provincial health card is sufficient...depending on where you enter Cuba, who is at the gate, how well trained or educated the person is on the issue, whether he or she is having a good day or not, which way the wind is blowing, etc., etc. In other words, it seems to be somewhat subjective, given that guidelines on the subject are about as scarce as toilet seats!

Unlike getting shots, I've decided to dodge a potential bullet by taking a printed copy of my health insurance - the part that pertains to foreign travel coverage. Most insurance companies should provide this, or be able to supply a letter of some sort, assuring that you're insured.

If you have neglected to check on this or to get something in writing to prove you're covered - or if you like to live more dangerously than I do - there should be no real problem, nonetheless. You should be able to buy insurance upon arrival in Cuba, theoretically, at the airport. According to some of my reading on the subject, personal coverage will be available for as low as 2.5 CUC per day (1 CUC is currently less than $1 CAD). The rate goes up if you are planning on participating in "high risk" sports like "alpinism, diving, parachuting, etc." or if you are over 70 years of age, which also seems to be risky business.

So, if you've forgotten any papers proving appropriate coverage, flashing your health card may be enough...or not. If not, purchasing health insurance upon landing in Cuba won't likely be ridiculously expensive, just an inconvenient annoyance. I guess the bottom line is, don't sweat it - you'll be covered, one way or another. And, hopefully, you won't need to test drive the highly touted Cuban medical system anyway!

One final thought: as with toilet seats, the associated paper products are often inconveniently absent; I've learned to carry a clump of toilet paper with me almost anywhere I to speak.

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