Abel Serra is 40 years old, has chronic kidney failure, and possesses a determination that defies exhaustion. This Cuban immigrant in Madrid works grueling hours at El Corte Inglés de Paseo de la Castellana and, upon finishing, spends up to five hours connected to a hemodialysis machine. He shared this himself in a post that went viral on Facebook, where he also manages the page "Descendientes Españoles con Abel Serra," a resource center for Cubans arriving in Spain.
His story begins with a decision without alternatives: “Hello, I am Abel Serra, a Cuban patient on hemodialysis, and I found myself needing to leave Cuba due to the conditions of the hemodialysis service there. Although it may not be evident, the mortality rate during hemodialysis treatments has multiplied by ten. Starting at 40 years old in a new country from scratch and with such a limiting illness is the toughest thing in the world, but it’s either that or die in Cuba.”
The figure you mentioned regarding mortality has not been corroborated by official Cuban or international sources, but the deterioration of the hemodialysis system on the island is a documented fact. In June of this year, patients in Camagüey went almost a week without treatment due to a lack of acid concentrate and bicarbonate. In Santiago de Cuba, the shortage of supplies forced a reduction of sessions from four hours to just two. The system serves about 3,000 patients across 56 units nationwide, according to the president of the Cuban Society of Nephrology.
In Madrid, Serra's routine is exhausting. On Tuesdays, Thursdays, and Saturdays, he works from ten in the morning until four in the afternoon, standing while receiving and organizing heavy boxes in the warehouse, constantly taking care not to damage his vascular fistula, the venous access without which he would not be able to undergo dialysis. On Mondays and Wednesdays, he works seven-hour shifts, and on Sundays, he works to make up for the hours he dedicates to dialysis sessions during the week.
"I feel bad when I can't take it anymore because I work every Tuesday, Thursday, and Saturday from 10 to 4 on my feet, after receiving orders of hundreds of heavy boxes and placing them in the warehouses carefully so that my fistula doesn't get damaged," she wrote in her Sunday post.
At the end of each day, the journey home is not a short one: two buses and a train, arriving past midnight with swollen feet. "I feel bad about getting home every day after 12 at night, taking two buses and a train, bathing while seeing my feet getting more and more swollen and painful, not eating because I lack the strength, or falling asleep with the bread in my hand and waking up the next day with it under my ribs," he recounted.
He arrived in Spain with Spanish nationality—obtained through descent—and with medical appointments already arranged, but without an ID or official residence registration. He sent out 30 resumes a day without any replies, until some 15-hour training courses, completed in two or three days, opened the doors to the job market for him.
What prevents him from giving up, he says, is the comparison with what he left behind: "But in Cuba, there are people who don't even have a vascular fistula to undergo dialysis. And in Cuba, many don't even have bread to eat."
His conclusion is as simple as it is powerful: "That's why I don't give up. That's why I keep going. Because I'm still alive here."
The struggle of Cuban kidney patients who emigrate to survive was documented by El País in late 2024, when entire families were taking their sick members out of the country due to the inability to guarantee treatment on the island. In 2024, around 38,179 Cubans emigrated to Spain, approximately 40% of whom had Spanish passports.
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