When electricity flows, staff work. When it doesn't, they wait.
En el municipio de Manatí, al norte de Cuba, la escasez de combustible ha obligado al sistema de salud a reorganizarse en torno a lo esencial: la sala de emergencias, el hogar materno y la casa de abuelos ahora funcionan con paneles solares llegados desde China. Es una historia antigua —la de comunidades que aprenden a sostener la vida con lo que tienen— pero también una contemporánea, marcada por las tensiones entre bloques geopolíticos que se resuelven, al final, en los cuerpos de quienes esperan atención médica. La innovación no borra la crisis; simplemente permite que continúe la resistencia.
- La escasez de combustible llegó a un punto en que solo la sala de emergencias podía mantenerse encendida de forma continua, consumiendo el generador más rápido de lo que el municipio podía reabastecerlo.
- Consultorios, laboratorios y clínicas dentales fueron apagados por turnos durante las horas pico, obligando al personal a reorganizar su jornada en torno a la disponibilidad de electricidad.
- La llegada de paneles solares desde China ofreció una solución parcial: las instalaciones críticas recuperaron suministro estable, pero la clínica dental quedó fuera por la alta demanda eléctrica de sus equipos.
- El personal ahora sincroniza sus turnos con el sol y las reservas de batería, convirtiendo la luz disponible en el eje invisible que organiza la atención médica.
- La ONU ha advertido repetidamente sobre el impacto del embargo estadounidense en el sistema de salud cubano, documentando restricciones al acceso de medicamentos, equipos diagnósticos y tecnología médica.
- Las autoridades de salud mantienen su compromiso con los estándares de atención, pero reconocen que ese compromiso se sostiene a diario sobre decisiones que hace pocos años habrían parecido impensables.
En Manatí, Las Tunas, la sala de emergencias permanece encendida gracias a paneles solares instalados en su techo. Lo mismo ocurre con el hogar materno y la casa de abuelos. Estas tres instalaciones se convirtieron en el núcleo irrenunciable del sistema de salud municipal cuando la escasez de combustible obligó a tomar decisiones imposibles.
Isabel Castillo Céspedes, directora de salud del municipio, describió cómo se fue construyendo esa jerarquía de urgencias. Al inicio, la estrategia fue apagar las oficinas no esenciales entre las 11 de la mañana y las 3 de la tarde. El laboratorio y los servicios de vacunación continuaron. La clínica dental funcionó junto a emergencias con el generador. Pero la crisis se profundizó, y eventualmente solo la sala de emergencias quedó con suministro continuo, alimentada por un único generador que consumía combustible más rápido de lo que podía reponerse.
Luego llegaron los paneles desde China. Se instalaron en emergencias, el hogar materno, la casa de abuelos y una residencia para adultos mayores. La clínica dental quedó excluida: sus equipos diagnósticos demandan más capacidad eléctrica de la que los paneles pueden ofrecer de forma confiable. La solución fue parcial, pero fue algo.
Hoy el ritmo del trabajo sigue el ritmo del sol. Los especialistas rotan turnos según la disponibilidad de energía; los procedimientos se programan en función de la luz y las reservas de batería. Castillo reconoció la tensión sin minimizarla: el sistema cumple sus metas de atención, pero solo porque todos aprendieron a trabajar dentro de límites que antes habrían parecido inimaginables.
La ONU ha documentado en reiteradas ocasiones cómo el embargo estadounidense restringe el acceso cubano a medicamentos, equipos y tecnología médica. Los paneles solares son una respuesta genuina a esa realidad, una forma de mantener servicios esenciales cuando el combustible se agota. Pero también son el síntoma de un problema más profundo: un sistema de salud que debe elegir qué servicios sobreviven y cuáles se apagan. Los paneles sostienen la sala de emergencias. No resuelven la crisis. Solo hacen posible seguir.
In the northern municipality of Manatí, Las Tunas, the emergency room stays lit by solar panels shipped from China. So do the maternal home and the house for the elderly. These three facilities have become the lifeline of health care in the region, kept running on a combination of diesel generators and rooftop solar arrays as fuel has become scarce enough to force impossible choices.
Isabel Castillo Céspedes, the health director for the municipality, explained the cascade of decisions that led here. When the fuel crisis began—a consequence of what Cuban officials describe as an energy blockade imposed by the United States—the health system had to triage its own survival. The emergency room was non-negotiable. The maternal home was non-negotiable. The elderly care facility was non-negotiable. Everything else became negotiable.
In the early months, the strategy was blunt: shut down offices that weren't essential during peak hours, between 11 a.m. and 3 p.m., when demand for electricity spiked. The laboratory stayed open. Vaccination services stayed open. The dental clinic ran on generator power alongside the emergency room. But as the shortage deepened, even these compromises weren't enough. Eventually, only the emergency room remained on continuous power, fed by a single generator that consumed fuel faster than the municipality could replace it.
Then the solar panels arrived from China. They were installed on the roofs of the emergency room, the maternal home, the elderly care facility, and a separate house for grandparents. The dental clinic was left out—its diagnostic equipment demanded more electrical capacity than the panels could reliably provide. The solution was partial, but it was something.
Now the rhythm of work has adapted to the rhythm of the sun. When electricity flows, staff work. When it doesn't, they wait. Specialists rotate their shifts to match the availability of power. Procedures are scheduled around daylight and battery reserves. Castillo acknowledged the strain without minimizing it: the system meets its care targets and serves the population, but only because everyone involved has learned to work within constraints that would have seemed unthinkable a few years ago.
The United Nations has issued repeated warnings about the conditions imposed on Cuba's health system. Official reports document how the embargo restricts access to medicines, diagnostic equipment, and medical technology. The blockade is economic, commercial, and financial all at once—a comprehensive restriction that leaves hospitals improvising with what they can build or import from willing partners.
Castillo insisted that her team remains committed to the health of Manatí's residents despite these limitations. The commitment is real, but it is also tested daily. The solar panels are a genuine innovation, a way to keep essential services running when fuel runs out. But they are also a symptom of a deeper problem: a health system forced to choose between which patients can be served and which cannot, between which services survive and which fade. The panels shore up the emergency room. They do not solve the crisis. They simply make it possible to continue.
Citações Notáveis
We try to shut down offices that aren't as necessary during peak hours, between 11 a.m. and 3 p.m.— Isabel Castillo Céspedes, health director for Manatí
When electricity comes, we work. The specialists rotate shifts and adapt their work to the availability of electrical flow.— Isabel Castillo Céspedes
A Conversa do Hearth Outra perspectiva sobre a história
Why did the solar panels arrive only after the fuel crisis became acute? Why not before?
Because Cuba didn't have the foreign currency to buy them until the crisis forced the government to prioritize health infrastructure in negotiations with China. Desperation became leverage.
The dental clinic couldn't use the panels. What happens to patients who need dental work?
They wait, or they don't get treated. The clinic still exists, but it operates on a generator when fuel is available. Dental care became a luxury the municipality couldn't afford to power consistently.
You mentioned staff rotating shifts around available power. How does a doctor explain that to a patient who needs emergency care at night?
They don't have to explain much. The emergency room runs 24 hours because it has priority access to both the generator and the solar battery system. But other services—the lab, imaging—those close when the sun sets unless there's fuel for the generator.
Is this sustainable? Can a health system actually function this way long-term?
It functions because people adapt. But adaptation isn't the same as sustainability. You can rotate shifts and schedule procedures around sunlight for months, maybe years. But equipment breaks down. Staff burn out. Patients get sicker waiting for care that could have been immediate.
The UN has warned about this. Does that warning change anything on the ground in Manatí?
It documents the problem. It doesn't solve it. The warning is important because it creates a record that this isn't a failure of Cuban medicine—it's a consequence of policy. But for the director and her staff, the warning is background noise. They're focused on keeping the lights on tomorrow.