Additional reporting by Washington News Editor Jonathan Wald
Dr Eugenio Selman is a man on a mission.
He is a passionate, tactile surgeon who grips my arm as he explains the plight of his hospital, Cardiocentro Pediátrico William Soler, the only specialist heart hospital for children in Cuba.
It must operate with less than half of its normal staff.
Faced with economic hardship that worsens daily, some have left for better-paid jobs elsewhere, some are unable to travel to work because of a lack of fuel, and others have decided to leave Cuba altogether.
It means Selman and the remaining doctors and nurses are struggling to help the children who have severe heart conditions.
Dr Eugenio Selman and his team are struggling to help children in the hospital Credit: ITV News
Some wards are closed because there is no one to run them.
Years ago, this hospital was one of the jewels of Castro’s health system and had no waiting list.
Now some 700 children are holding out for operations, facing months of delays, discomfort and risk.
Dr Selman blames the US blockade for the deteriorating situation.
The Americans insist they have not blockaded medicines.
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An American official told ITV News that “medicines are and have always been exempted”.
“The regime’s failed policies and corrupt leadership have caused the Cuban people immense hardship,” the official went on to say.
“Regime leaders squirrel away billions in foreign accounts while everyday Cubans go hungry and without medicine.”
But Dr Selman claims obtaining equipment like catheters, specialist antibiotics to treat infection like the drug Amphotericin, or drugs like Adenosine, used to treat the heart condition, arrhythmia, are fraught with red tape and delays.
He also fears companies that may be technically permitted to provide medicine and resources are intimidated by the potential loss of business with the US if they are seen to be trading with Cuba.
Some 800,000 Cubans are currently applying for Spanish citizenship Credit: ITV News
While that is part of the story, so too is the exodus of skilled staff from this country.
Some 800,000 Cubans are currently applying for Spanish citizenship in order to leave the country.
That represents almost 10% of the approximately 10 million population.
“El ley de nietos” or the “Law of Grandchildren” enables anyone who can prove they have a grandparent to apply for citizenship.
Each day, dozens line up outside the office where applications are processed.
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Among them is Jonathan Adaj, who installs solar panels.
His sister is about to receive her Spanish passport, and he’s hoping he will be next.
He has plans to move to Madrid if he is successful, taking his much-needed skills with him.
In a country with crippling shortages of electricity, solar panels could offer some relief for struggling businesses, but Jonathan’s departure is emblematic of the problems Cuba’s government is facing.
We visited Envametal, a factory where a solar system has been installed to power the administrative offices.
Jonathan Adaj is hoping to leave Cuba for Madrid Credit: ITV News
While we were visiting, there was a power cut, but their computers and lights remained operational due to the new panels on the roof.
But it cannot provide enough for the factory itself, which manufactures aluminium and tin products.
After the power does not come back on for two hours, the workers are sent home for the day.
This is further hobbling Cuba’s command economy, which these days is contending with rolling blackouts sometimes lasting days.
Tourism used to provide a financial lifeline, but that too is on its knees.
Cuba is not seeing its usual number of tourists Credit: ITV News
We went to the home of Nobel Laureate Ernest Hemingway, which normally attracts 300 visitors a day.
Yet we were the first foreigners there for two weeks.
His mansion, once the playground of Hollywood stars and literary giants, is now empty except for the staff who wait in the hope of a single visitor.
The Trump administration is hoping this maximum pressure will force the government of President Miguel Diaz-Canel to change course and enter meaningful negotiations with the US to open up and abandon its communist principles.
However, there is no sign of compromise from a government which still reveres Fidel Castro and his 95-year-old brother Raul, who was recently indicted by the US Department of Justice.
The government’s defiance is entrenched, but so too is the growing fatigue of ordinary Cubans, many of whom feel let down by 67 years of communist ideology, which has left many of them starkly poorer than their Caribbean and Central American neighbours.
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