Staff from Havana’s William Soler Pediatric Cardiocenter Hospital, which receives humanitarian aid from the Nuestra America flotilla from Mexico, speaks with flotilla delegates in March..Yuri Cortez/AFP/Getty
As Cuba’s worst economic crisis continues to ravage the country, its approximately 10 million people have endured nationwide blackouts, scarce food, and a pervasive sense of anxiety about their country’s political and economic stability. But no part of the infrastructure has been more affected than the island’s medical care. Once lauded as one of the best health care systems in the world, it has deteriorated in the last decade as many doctors migrated elsewhere, and medical supply shortages have worsened due to failing economic policies. The situation reached a breaking point earlier this year, following the US invasion of Venezuela on January 3, 2026. That’s when the crucial supply of oil to Cuba was cut off, and President Donald Trump threatened other nations with punishing tariffs should they send oil to the island. The US government recently softened its stance, the New York Times reported on Monday, and will decide which oil shipments can arrive in Cuba on a “case-by-case basis.”
The lack of fuel has prompted island-wide power outages that last several hours, sometimes even days. “You cannot damage a state’s economy without affecting its inhabitants,” Cuba’s Health Minister, José Ángel Portal Miranda, told the Associated Press. “This situation could put lives at risk.” A recent New York Times story chronicled the myriad of problems affecting patients and providers: clinics struggling to provide treatments like chemotherapy and dialysis, ambulances left without gas, underweight pregnant mothers, and vaccine delays for tens of thousands of children. Last week, Dr. Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization, called the situation “deeply concerning.” He wrote on X, “Thousands of surgeries have been postponed during the last month, and people needing care, from cancer patients to pregnant women preparing for delivery, have been put at risk due to lack of power to operate medical equipment and cold chain storage for vaccines.”
Economic ties between the US and Cuba are restricted under the decades-old embargo, which began in 1962 under President John F. Kennedy following the failed Bay of Pigs invasion. As I reported last month, the embargo severely limits commerce with the island. It does, however, allow for some exceptions, such as humanitarian aid. Since 1994, the Pittsburgh-based nonprofit, Global Links, has shipped medical supplies to Cuba under a partnership with the Pan American Health Organization, the WHO Regional Office for the Americas. For more than three decades, the nonprofit has distributed surplus medical products from the US healthcare system locally and abroad.
I spoke with Global Links executive director Angela Garcia on a Zoom call last week about the organization’s mission to send supplies to Cuba’s medical providers in recent months. Our interview has been lightly condensed and edited for clarity.
You last visited Cuba in February. What struck you the most about the country’s ongoing crisis during that trip?
Cuba has one of the fastest aging populations. With migration out of the country, there are a lot of older adults who are living in very challenging situations and now have to cook over charcoal outside due to the power outages. Malnutrition is hitting the oldest population and the very youngest the hardest. And doctors don’t have a lot of choices— triaging surgeries that they’re forced to do because of the shortages and the lack of power, consolidating hospital services, and triaging which patients get the highest level of care. They are being forced to make these types of decisions. More people will die of preventable things there than they would have before. That’s what’s most heartbreaking.
“More people will die of preventable things there than they would have before. That’s what’s most heartbreaking.”
What did you hear from medical providers on the ground about the state of their health care facilities? What resources are most needed?
They’re asking us for things that are so basic, for example, gloves. Best practice is that you use a glove, and then you throw the glove away. They’ve gotten to the point where they’re washing and reusing gloves, which we have seen in many places around the world. It’s not that they don’t know that’s not ideal. It’s the reality of [the fact that] there’s no glove after this, so we’re going to wash and reuse it. It doesn’t have to be this way. These are a series of human-made decisions that put patients in a position where they’re not able to get care, even if it’s known by doctors what the care needs to be. From a humanitarian perspective, this is not like after a hurricane. This is not like a civil war. This doesn’t have to be this way.
I was meeting with a group of hospital directors I’ve worked with for the past couple of years. When I ask them, what are the top three most needed products, they’ll say medical gloves, surgical gloves, sutures, or IV catheters. And I asked, what else besides that? And they said adult diapers. I just didn’t expect that. They said, well, because of the personnel shortages and because of the older population, before we leave at night, we want to make sure they have adult briefs on because if they get up in the middle of the night and slip and fall or have an accident, they have a much more serious health issue. That to me just spoke to the humanity of hospital leadership and top surgeons thinking, how do we minimize a severe situation? How do we do the best we can for our patients, despite the shortages, despite the power outages, despite the personnel shortage? That just sort of hit me.
What is the shipping process like for aid that goes to Cuba, and with all the different needs right now, how do you prioritize what to send?
We ship by the most cost-efficient method, which is the back of a 40-foot semi truck that goes on a container ship. We’ve sent one every time we raise $25,000. So, in the past 12 months, it’s been about every two to three months. We send large quantities of gloves, wound care bandages, gauze, incontinence products, supplies for intubation and delivering babies, and vaccine syringes. We look at how do we decide what we ship when the needs are so big? And we know what those things are. We have to continue to support women having their babies, the surgeries that are being planned, pediatrics, and the older adult population. So that’s what we look at with each container. And then just start on the next one and do the same thing over again.
What challenges has your organization faced in sending supplies due to the ongoing fuel shortage?
The logistics are the biggest challenge. Once you ship a container, it’s just as if you mailed a package. If you mailed it with FedEx or UPS, to actually change the end destination once it’s out there, is not easy—if you can do it at all. With each container that has left since last fall, we’ve had to update the shipping line with the final destination. We’ve had the WHO in Havana tell us, it can’t come into Mariel, it has to go to Santiago. And then one was destined for Santiago, we had to do the reverse, and that adds cost on our end. But if they can’t pull it out when it gets there, there’s no point, right? So there is a congestion that we have to work through on literally, a day-by-day basis to ensure that as the containers are heading down, they get to the port where WHO can get to the container and pull out the supplies, which we’ve never had to do before.
That sounds like so much work. How do you manage to adapt so frequently?
It’s what we’re set up to do. Cubans need us more than ever. They’re communicating what those needs are. People can support what we do, and that, in turn, supports Cubans in their time of need.
