Cuban Patients Are Dying Because Trump's Blockade of Cuba
As a nationwide blackout in Cuba stretched into a second day this past weekend, the stakes were rising for Jorge Pérez Álvarez.
The 21-year-old suffers from a genetic disease preventing his lungs from pumping air on their own. He needs a ventilator at all times to keep breathing.
His ventilator’s backup battery is supposed to last more than a day, but that has been tested repeatedly in recent weeks, including three nationwide outages that each pushed up against its limits. And with the power out for hours every day, there is hardly enough time to recharge it.
“I don’t know how long we can keep going,” said his mother, Xenia Álvarez, standing near her son’s crumpled body in his bedroom in a poor neighborhood of Havana. “His life depends on electricity.”
The U.S. oil blockade on Cuba is fast exhausting the country’s supply of fuel, causing daily blackouts, food shortages, canceled classes and black-market gas prices approaching $40 a gallon. It is also crippling Cuba’s universal health care system, a state institution once considered a triumph for a poor nation, but is now struggling to provide basic care.
In interviews, six Cuban doctors said that rapidly deteriorating conditions at hospitals and clinics across Cuba were causing deaths that would otherwise be preventable.
“I can’t tell you how many deaths, but I’m sure there are more than in the same period last year,” said Dr. Alioth Fernandez, chief anesthesiologist at Havana’s largest pediatric hospital. “I see it in shift handovers, in colleagues’ comments and in children I’ve operated on.”
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The blockade’s effects are cascading through the system. Hospitals are canceling surgeries and sending patients home because doctors and nurses can’t commute to work. Clinics are struggling to administer treatments like chemotherapy and dialysis because of power outages.
Many ambulances are parked because drivers can’t find gas. Pharmacies are largely empty because the virtually bankrupt state is struggling to buy medicine.
Production of medicine has been mostly halted because factories run on diesel. Vaccine makers are searching for ingredients because flights that once carried them are canceled because of a lack of jet fuel. And refrigerated vaccine stocks could soon spoil if the blackouts continue.
“This is not subtle, this is extreme,” said Paul Spiegel, a public health expert at Johns Hopkins University who has led public health responses in Afghanistan, Ukraine and Gaza. “You’re already seeing hospitals changing how they are operating.” As happened during crises in those other places, he said the conditions were forcing Cuban health workers throughout the system to triage patients. “The magnitude and who will be affected will depend on these horrible decisions they have to make,” he said.
The blockade is compounding problems that were already mounting for Cuban health care.
While Cuba’s stagnant state-planned economy and international isolation have fueled decades of widespread poverty, the nation’s free health care system has long been a bright spot. That is in part because the government has spent about a fifth of its budget on health, about twice the global average, according to the World Health Organization.
Until the Covid-19 pandemic, life expectancy and infant mortality rates in Cuba were comparable to those in developed countries, while doctor-to-patient ratios were among the world’s best, according to the World Bank.
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But stricter U.S. sanctions on Cuba, which began under the first Trump administration, have posed major challenges. They have prevented hospitals from replacing aging equipment, complicated international payments and logistics, and caused U.S. and European medical suppliers to halt contracts because they feared running afoul of U.S. rules. Economists estimate the sanctions also cost the state billions of dollars in lost income.
Those sanctions, along with the pandemic and Cuba’s failed economic policies, have led to a deep recession. The state’s major bet on tourism, including millions of dollars invested in towering hotels, backfired. Mistimed monetary policies destroyed the value of the Cuban peso, driving down the already minuscule average state salary to the equivalent of $13 a month. And despite a slow opening of the economy, the Communist government’s political repression has disabled true economic alternatives.
In 2018, the infant mortality rate in Cuba was four per 1,000 births, lower than in the United States. By 2025, that rate had more than doubled, to 10 deaths, almost twice as high as the U.S. figure.
The sanctions’ consequences took several years to ripple through the health system, said Ruth Gibson, a Stanford University doctor who studies the impact of sanctions on public health. The impact of the oil blockade, she said, “will likely be exponentially more severe.” Dr. Liliam Delgado Peruyera, an obstetrician-gynecologist at Cuba’s leading maternity hospital, said the damage was already clear.
Sanctions helped leave the hospital short on antibiotics, medicine and equipment, while food shortages have been leading to more underweight pregnant mothers and their newborns. Now doctors, nurses, cleaners and mothers all struggle to get to the hospital because of the lack of fuel. This translates into dirtier delivery rooms, fewer health workers to deliver babies and mothers arriving after labor is dangerously far along.
“We are receiving much more severe cases,” Dr. Delgado Peruyera said, noting that three newborns died in February, the most she could ever recall in one month. “Especially in recent weeks — extreme prematurity has hit us hard.” She attributed the increase in premature births partly to rising infections because of a shortage of antibiotics.
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The Cuban government said this month that 96,400 patients were awaiting surgery, though it was unclear how many were added to the list since the blockade. Fuel shortages have delayed vaccines for more than 30,000 children, the government added, and caused inconsistent radiation therapy and kidney dialysis for nearly 20,000 patients.
Medicine is also in desperately short supply. This month, a pharmacy in one poor Havana neighborhood was locked in the middle of the workday and its empty shelves could be seen through a cracked window. Handwritten signs on the door warned customers that purchases were strictly limited. “It’s been reported that people are reselling medicine, and thus we’ll inform the police,” one sign said.
Across town, the William Soler Pediatric Hospital was eerily quiet. The hospital is operating with a skeleton staff, with many doctors, nurses and patients trudging miles under the Caribbean sun to get there.
The government prioritizes electricity for hospitals, which helps to keep their lights on when other parts of the city are dark. Yet this month, hospitals have had to rely on backup generators during three nationwide power outages.
Dr. Fernandez, the chief anesthesiologist, was keeping a 2-month-old boy sedated during surgery when one blackout hit. The lights and equipment monitoring the baby’s vital signs suddenly went dark for a few minutes, until the generator kicked in. “When you’re in the middle of it,” the doctor said, “it feels like an hour.”
Elsewhere in the hospital, doctors and nurses dashed to ventilators that were pumping air into the lungs of sick newborns. The machines’ battery systems died years ago, so health workers have to squeeze a rubber pump to keep the babies breathing until the generators start to work. With fuel running so short, the gas generators may be only a temporary savior. Nurses in the hospital’s neonatal unit said they already have plans for a fully powerless hospital: swaddle newborns in blankets and put them back into dead incubators, hoping they stay warm enough to survive.
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Cuba’s last shipment of oil arrived on Jan. 9. Nations had halted shipments after threats from President Trump, but now eyes are on a Russian tanker that could arrive by early next week.
President Miguel Díaz-Canel has warned Cubans that the nation’s power grid is deeply unstable and that thing are likely to get worse.
In response, the government has installed solar panels on neighborhood health clinics and nursing homes, as well as the homes of 120 sick children who require access to air-conditioning. The government said it has also given solar panels to 10,000 health and education workers so they can work remotely.
But new challenges are cropping up across the island. Taps are running dry because water pumps depend on the failing power grid. Sanitation is getting worse. And food is becoming harder to find, according to the top United Nations official in Cuba.
One hallmark of the Cuban health care system was regular packages of food, supplements and medicine for new mothers and infants. As a result, until the pandemic, Cuba had one of the lowest rates of child malnutrition in the region, according to UNICEF.
Cuban mothers and their doctors said those monthly deliveries have been arriving smaller and far less frequently. Dr. Roxana Martínez Rodríguez, a community doctor in one Havana neighborhood, said this year her patients haven’t received any milk or supplements like folic acid, which the state once provided regularly. That is occurring as overall food prices have shot up since January, another result of the soaring cost of fuel.
“A salary is barely enough for breakfast,” Dr. Martínez Rodríguez said. “It’s a luxury to buy a cabbage.”
She said she was seeing more malnourished infants as a result.
Dr. Martínez Rodríguez said her patient load has doubled in recent years, to 1,930 patients, because many doctors and nurses have quit the health system for higher salaries in the growing private sector, while others have left the island. The remaining health workers are exhausted, especially since they must deal with the same daily challenges of life as their roughly 10 million fellow Cubans.
“We have the same blackouts as the rest of the population, we face the same shortages,” she said. “And whether you want it to or not, it’s going to affect you.”
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