Dengue Outbreak Tests Havana Hospitals

Hospitals in the Cuban capital Havana are so overburdened by admitting patients with dengue fever that they are failing to maintain basic hygiene, staff and patients’ relatives say. 

A nurse at one hospital in the city said a shortage of cleaning staff in overcrowded wards set aside for dengue fever cases meant that hygiene standards were not being maintained.

Speaking on condition of anonymity, she hospitals across Havana were overwhelmed with suspected dengue cases.

“In hospitals like Julio Trigo, Miguel E. Cabreras and Hijas de Galicia, health officials are advising that due to insufficient capacity, only severe cases of dengue should be admitted, with pregnant women and the elderly made the priority,” she said.

Dengue fever, a disease transmitted by the yellow fever mosquito (Aedes aegypti), has been reported in several Cuban regions in recent months. In August, the health ministry was quoted as saying mosquito infestation had reached “critical” level in 23 municipalities, 15 of them in Havana province.

Epidemiological statistics are kept confidential, so the nurse based her assessment of the scale of the outbreak on her own observations. She said the Arroyo Naranjo municipality, part of Havana city, had the highest recorded incidence of dengue fever infection and also fatalities.

In Arroyo Naranjo, conditions at the Arturo Aballí maternity and paediatric teaching hospital got so bad that parents started taking their children home.

When Vladimir Peña and Yamilé Ortega brought their six-month-old daughter Emily in to the hospital on August 24 with a fever suspected to be dengue, they were shocked at what they found there.

“When we arrived, we found that limited capacity meant Emily had to share a cubicle with confirmed cases,” Ortega said.

Peña described “cubicle and hallway floors covered in rubbish, food, bloodstained dressings and cotton balls, as well as children’s vomit and faeces. To top it off, the majority of the bathrooms were closed because [the plumbing] was blocked up.”

He and other parents repeatedly asked hospital managers to institute a clean-up, but received only “evasive and vague” answers about why the place was in such a state.

“Aside from the inefficiency of it, what was most infuriating was that no one was able to offer a logical explanation as to why our children had to be surrounded by filth,” he said.

As their child’s fever did not return within 72 hours, the couple decided to take her home on August 29. Nine other sets of parents whose children were suspected rather than confirmed cases followed suit.

One father, Augusto Barbosa, said the unsanitary conditions placed fever-weakened children at greater risk.

“I brought in my four-year-old daughter to see her get better, not to have her pick up an infection,” he said.

A few days after Peña and Ortega took their daughter home, they were visited at home by staff from the teaching hospital and from the health clinic in their neighbourhood, Managua. They asked Peña to sign a statement taking responsibility for removing his child from the hospital without the approval of a specialist doctor.

“I refused to sign anything,” he said. “I don’t consider myself responsible for what happened. Under normal conditions, the girl would have stayed there under observation for the necessary period.”

He added, “If I need to go to a hospital again, it won’t be the Aballí.”