‘I cannot think of anything worse’; Cuban doctor struggles to treat cancer patients amid energy crisis

Journalist notes

Brenda González Betancourt

Interview subject:

Mildrey García Hernández, 51, is a Cuban doctor specializing in comprehensive general medicine and oncology. She serves as head of Oncology Services for the province of Matanzas, on Cuba’s northern coast, where she lives. After earning her medical degree in 1999, she qualified as a specialist in comprehensive general medicine in 2004 and completed her specialization in oncology in 2022. Additionally, she holds a master’s degree in diagnostic procedures. Throughout her career, she has cared for patients in Cuba’s public healthcare system.
In addition to her clinical work, she chairs the Matanzas Chapter of the Cuban Society of Oncology and serves as president of the Academic Committee at the Faustino Hernández University Clinical and Surgical Hospital in Matanzas, responsibilities that add to an already demanding professional role.

Background information:

As the conflict among Iran, Israel and the United States escalates, fuel prices around the world have risen, largely due to the closure of the Strait of Hormuz, a route through which much of the world’s oil supply passes. After briefly reopening last week upon President Trump’s signature on a memorandum of understanding, the key traffic lane was closed again on Saturday, June 20, in response to U.S. and Israel violations of the ceasefire agreement, Reuters reported.
With crude shipments under continual threat since late February, countries have been paying increasingly higher prices for this resource.
In this context, nations like Cuba, which are heavily dependent on imports and lack the financial capacity to absorb higher costs, have been pushed to the brink. By the time the strait was closed, Cuba was already grappling with an energy crisis driven by U.S. sanctions on a number of countries. 
The disruption of Venezuelan oil exports following the capture of Nicolás Maduro on Jan. 3, restrictions that halted fuel supplies from Mexico, an aging energy infrastructure, and persistent logistical and refinancing challenges, among other factors, mean that Cubans have been hit harder by this energy crisis than people in many other countries.
While the island nation’s problems are rooted in domestic structural issues, the  Trump administration has contributed to accelerating and worsening existing problems, including insufficient electricity generation, a growing energy deficit that has triggered power outages lasting 72 hours or more, and a near-total breakdown of public transportation.

Keeping radiation therapy operational means more than caring for equipment so old it belongs in a museum. We also have to make sure there is enough fuel to keep the generator running for more than 12 hours and to transport patients when needed. This is not something we can take for granted these days.

The rest of the challenges are unpredictable, ranging from shortages of basic supplies to the collapse of essential services. Hospital staff know that radiation therapy could be brought to a halt at any moment, as fuel is often in short supply and generators risk failing under the strain. Plus, transportation problems can prevent doctors, nurses, and patients from reaching the hospital.

Back to the beginning: Life before the crisis

From a very young age, I remember being curious about diseases and how they could be cured. While I was studying medicine and during the first years of my career, the healthcare system was incredibly different from what it is today. 

Our clinics were well equipped. We had the supplies needed to sterilize medical instruments, and we were able to run cytology tests. When a patient needed to be transported to the hospital, there was always an ambulance available.

We also had access to essential specialists. Internists, obstetricians and pediatricians regularly visited our area, and the local pharmacy could fill prescriptions because the medicines people needed were on the shelves. 

After qualifying as an oncologist, I worked in healthcare facilities in both provincial and city settings. I was able to carry out basic diagnostic studies, provide first-line treatments, and experience the satisfaction that comes from knowing my work is genuinely improving people’s lives.

I could imagine a future shaped by technological advances and better care. I thought we would have modern equipment and that patients would be able to receive high-quality treatment closer to home, without constantly being referred elsewhere. 

How short my dreams fell. Today, even when we are doing the work we love and putting our hearts into it, it is difficult to feel fulfilled because we do not have the means to provide the care our patients need, and we do not see the results we know are possible. It’s extremely frustrating.

Every aspect of life impacted

The shortage of oil and fuel in general in Cuba has affected every aspect of daily life. Family life looks quite different now, with new challenges constantly reshaping our priorities. When we work, we are no longer thinking about taking a relaxing vacation, buying something new for our homes — whether out of necessity, for a little extra comfort, or simply as a treat — or being able to support our children’s dreams. 

‘Today, our priority is making sure we have electricity during the day and, above all, at night. We worry about what fuel we will use to cook, clean and light our homes, and about how we will keep our food from spoiling.’

In practice, we spend every hour of the day thinking about how to stretch our income a little further. The fuel crisis has arrived hand in hand with rising inflation, driving up the cost of basic goods beyond what many Cubans can afford on their salaries. 

And, of course, we hope our loved ones stay healthy, because medicines are expensive and not always available.

In December 2024, I had to start making decisions to cushion the impact of the energy crisis that predates the United States’ conflict with Iran. Returning home to a power outage had become my new normal. 

I used my savings to buy a generator. When I was unable to secure fuel for it, I got an EcoFlow battery, although there was not always enough electricity available to keep it charged. 

Later, I purchased a solar panel and a charcoal stove, so I could at least prepare meals. Salaries are no longer sufficient to cover basic expenses, so we do what we can to adapt while continuing to commute, work, buy food and find ways to cope with whatever unforeseen challenge comes next.

Remaining resilient in the face of scarcity 

Nowadays, each day begins with questions no one can answer, and for which  no one really takes responsibility: 

How will I get to work today? 

What transportation will be available? 

How long will the journey take? 

How much will it cost? 

Once we, as healthcare providers, arrive at the hospital, we are confronted with an unprecedented shortage of medicines and the distress of caring for people whose lives depend on us while having little, if anything, available to offer them.

The only real alternative to the constant power shortages is solar energy, but the much-discussed goal of “energy sovereignty” remains a distant reality, and the system is still unable to support all the equipment we rely on. 

The shortages, the difficulties in securing fuel for hospitals and clinics, and the growing strain these problems place on the healthcare system have combined to create a crisis. 

It is hard to explain, and harder still to understand.

I have not left the profession because medicine is the only career I ever dreamed of pursuing, and both my family and I have sacrificed a great deal to get me where I am today. I love what I do, and I have found it deeply fulfilling. 

I could pursue a better-paying job, but walking away from medicine would mean losing my license and abandoning everything I have worked for. And it’s not like I could practice medicine elsewhere. We are subject to regulations that prevent us from leaving the country.

With my knowledge and training, I cannot imagine giving up healthcare and losing the ability to help others, including my own family. I like being a physician. I like being able to heal people. My son and his girlfriend are both studying medicine, and I want to set a good example for them.

An uphill battle

Day-to-day life at the hospital has become a constant uphill battle. People are extraordinarily vulnerable, not only because of their illnesses, but also because of the hardships they face and the rising cost of living.

At times, their frustration is directed at physicians, as we are the visible face of the system. On top of that, we spend part of our working day trying to solve problems that fall well outside our responsibilities — simply because no one else will.

Many of us end up setting aside some of our duties as we search for ways to keep services running. Healthcare workers ask for and need the minimum conditions to do their jobs, while department heads ask them to persevere and be resourceful. 

Too often, however, that means being asked to achieve the impossible, to try to do something that is well beyond our reach.

Translated by Mariela Iñiguez