The director of a tourist hospital stated that his institution is largely unaffected, since it earns hard currency with which to purchase needed supplies. But ordinary Cubans do not have access to tourist hospitals. He conceded that he did not know how the expensive medicine used to treat such patients would be procured in the future. The cutoff of primary materials from the Eastern bloc has not only affected the supply of medicine, but also created shortages of soap, detergent, and chloride used to treat the water supply. Shampoo is rarely available.
Detergent is scarce, forcing people to wash their clothing in water alone.
The loss of paper imports also threatens health. Personal hygiene is markedly deteriorating in Havana. People interviewed said that the felt filthy, and many were. Finally, the crisis has resulted in a lack of pesticides, and fumigation efforts aimed at controlling mosquitoes, cockroaches, and other insects have been curtailed. In addition to the absence of medicine, shortages of all sorts of spare parts affect health care.