The director of the Havana Psychiatric Hospital was sentenced in January by a Cuban court to 15 years in prison for negligence after 26 patients died of cold in January 2010.
A dozen other hospital staff members received sentences of five to 14 years for their roles in the tragedy.
The hospital staff did not provide enough blankets and warm clothes to the patients and failed to board up broken windows or move patients to warmer areas during a night when temperatures dropped to 38° F, said prosecutors.
Patients also showed signs of malnutrition, anemia, and vitamin deficiencies, they said. Hospital staff were accused of diverting "resources intended primarily for the feeding of patients, as well as clothing and undergarments allotted for their protection," according to the official Cuban Communist Party newspaper Granma.
The hospital received enough supplies to feed 2,458 patients, but the average occupancy was 1,484, which should have guaranteed enough food for all. Similar failings were noted for other supplies and clothing.
The nongovernmental Cuban Commission on Human Rights said the incident was "the highest number of avoidable deaths in a Cuban hospital in the history of the republic," and that it reflected "growing signs of deterioration" in the Cuban health system, according to the BBC.
Much of that deterioration has happened since the Soviet Union broke up, leading to the end of subsidies for Cuba.
"There have been prior tragedies, but this was unprecedented in scope," said Rigoberto Rodriguez, M.D., of Miami, chair of the ethics and human rights committees of the Florida Psychiatric Society. Rodriguez was born in Cuba and came to the United States in 1966.
The punishments were severe, but he fears that those convicted will not serve their full sentences, once the event and the trial fade from memory.
Rodriguez visited the same hospital in 1999 and found the buildings and residents in poor condition. The forensic ward then housed political dissidents who were "tortured with medications and electroconvulsive therapy," he said.
News reports indicate that little has changed since then. Current patients are described as looking extremely malnourished.
Last May the APA Assembly sent an action paper to the Joint Reference Committee (JRC) asking the Board of Trustees for a position statement on the tragedy and on the unrelated death of a political prisoner who was on a hunger strike.
The JRC referred the matter to the Council on Psychiatry and Law, which said, according to its minutes, "it would be inappropriate for APA to take a position on a specific event … without an investigation into the underlying facts …, [and] it would be difficult, given the state of U.S.-Cuban relations, for a U.S.-based organization to conduct a full investigation."
In October, the JRC referred the matter to the World Psychiatric Association as a more appropriate body to deal with the two cases.
