Patients, practitioners, and paradoxes: responses to the Cuban health crisis of the 1990s.

Twenty-one respondents in Havana, Cuba, were interviewed for the purpose of understanding the challenges facing the Cuban health care system since the 1990s and the individual solutions that have been proposed to these challenges. Three major shortages were identified: a lack of medication, a lack of medical supplies, and a lack of medical professionals. Consequently, informal coping mechanisms, such as the black market and using personal connections, were a common way of overcoming the difficulties associated with these shortages. Beyond this, however, Cuban health care has experienced a unique fusion of medical traditions, such that now biomedicine and complementary and alternative medicine not only coexist in Cuban society but actively collude together to respond to the increasing demands for health services in light of waning supplies of medication and medical supplies. As a result, Cuba has managed to survive its most difficult health crisis since the beginning of the Revolution.