Black Market is Profitable for Doctors

Black Market is Profitable for Doctors / Julio Cesar Alvarez
Posted on August 12, 2013

HAVANA, Cuba, August www.cubanet.org. A good part of the staff in the
network of Havana pharmacies, in collusion with doctors in medical
offices, clinics and hospitals, sell the medications from these
establishments at a premium price, as if they were private businesses.

The lines in doctors' offices, hospitals or hospital outpatient
services, coupled with the lack of doctors, who are serving on
"missions" in other countries*, contribute to turning any kind of pain
into a difficult problem. To get a prescription for a painkiller can be
half a day's work.

To resolve this problem, many staff at the pharmacies offer an
alternative but illegal service: They sell drugs without proper
prescriptions. Thus, patients avoid having to go through the doctor's
office. All they have to do is buy the medicine at a higher price.

The client

Jose Manuel, self-employed in the municipality of October 10, woke up a
few days ago with pain in the neck. Neither he nor his neighbor had any
painkillers. He went to the family doctor's office, but the doctor was
"on a mission" in Venezuela. The nurse told him the new doctor hadn't
come to work. At another doctor's office they told him they only saw
pregnant women. Then he went to the pharmacy to try to negotiate for
some painkillers. The clerk said that without a prescription he couldn't
supply them; however, as he knew he was a regular customer, he said he
had a solution for him.

The solution for José Manuel was to pay four times the price of the
drug. The blister-pack of 10 tablets of pain medication that would cost
0.70 cents in local currency with a prescription, could be had now
without prescription for 5 pesos.

The clerk

According to a source who works in a Havana pharmacy (who declined to be
identified), she can earn more than 150 pesos, national currency, in one
day**, selling drugs without prescriptions. "The thing is not so
complicated. We have doctors who supply our prescriptions. They charge
us 1 Cuban currency for each prescription. That way we can sell 'under
the table' all the medicine we want, because they are backed by a
medical prescription."

She further claims that most of the clerks take the prescriptions home
for family and friends to fill them out. Thus, they avoid that these
documents show the handwriting of the pharmacy workers. They also try to
find different doctors who sell prescriptions, so as not to repeat too
much the stamp of the same doctor. Although among the doctors who engage
in this activity they exchange prescription pads, so that their identity
does not appear too often in the same pharmacy.

The source added that to avoid getting caught, each clerk serves a known
clientele. The rest of the medicine they take home and give them to
third parties to sell. A pack of 150 grams of cotton can cost $2 on the
black market. A tube of Micocilén powder, $1. Creams and ointments, 10
pesos a tube. The Meprobamate blister-pack with ten pills, 10 pesos.

Another opinion

Dr. Silvia recognizes that there are patients who need medications, and
find it difficult to access a prescription, for one reason or another,
but she considers that the majority of consumers who access medicine in
this way are those who self medicate: "There people who need to have a
kit with the full range of potential drugs, and not just because they
think they will be unavailable, but because today they take Duralgina
for one pain, and tomorrow Ibuprofen or Paracetamol because they believe
that Duralgina no longer has any effect. Some people take Meprobamate,
then say they can not sleep, and there are an endless number of examples
like this."

But whatever the reasons that patients take the medications, the fact is
that this market in Cuba is profitable for the white coats.

Translator's notes

*Doctors on missions: A main source of income to the Cuban State is the
money charged for doctors and other medical personnel who are sent
abroad "on missions." The State collects many times what it pays each
doctor.
**150 Cuban pesos is roughly $6.25 US, which is more than a week's
average salary in Cuba.

ABOUT THE AUTHOR

Julio César Álvarez López (b. 1968) Graduated in 1990 from the Hermanos
Martinez Tamayo School of Counterintelligence. Arrested in 1992 for
collaborating with Human Rights Groups and sentenced by a military court
to 19 years, of which he served 16, seven of them in the Maximum
Severity Prison of Camaguey. He was paroled in April 2008 and studied
computing and digital photography at St. John Bosco church. He speaks
English and is currently studying German. He lives in Havana.

From Cubanet

5 August 2013

Source: "Black Market is Profitable for Doctors / Julio Cesar Alvarez |
Translating Cuba" -
http://translatingcuba.com/black-market-is-profitable-for-doctors-julio-cesar-alvarez/