The family of a Manitoba woman who got sick in Cuba and died a day after getting back to Canada is warning travellers to be prepared for every emergency.

Barb Johnston, 54, of Oak Lake, Man., died on Dec. 29 at the Brandon Regional Health Centre, following a month-long illness that started in Cuba, where she and her husband, John, had travelled for one of their regular sun vacations.

Barb developed flu-like symptoms on Nov. 26 while staying on Cayo Santa Maria, said her husband, John. She took a turn for the worse and they headed to a medical clinic on Nov. 27, he said.

"The resorts are absolutely gorgeous where the tourists are, the facilities are beautiful, the beaches are amazing," John said. "But once we got to the medical centre, it was a horrendous shock.

"It was very dirty, everything had rust on it, there was no doors on anything, everyone seemed to be in their street clothes."

Johnston family

Barb Johnston with sons Riley (left) and Ryan (second from left), husband John and son Derek (right) in their Oak Lake-Sifton volunteer fire department uniforms. (Supplied )

Staff at the clinic had her transferred later that morning to a hospital more than two hours away on mainland Cuba. She was admitted to the intensive care unit, put on a ventilator and treated for septic shock.

The hospital didn't have food, water or public toilets that worked, the family said. Sinks were also few and far between. At one point, hospital staff asked the family to go and bring back orange juice and push it though Barb's feeding tube, the said.

Few spoke English at the hospital and getting any information was difficult, John said.

"It was very basic medical care," said their son Riley, who is a paramedic in Manitoba. "The Cuban doctors were doing medical practice from years ago. They didn't have up-to-date medical practices and stuff like that."

Johnston family 2

John Johnston and sons Riley, Derek and Ryan speak to the CBC on Tuesday, Jan. 12. (Riley Laychuk/CBC)

Barb stayed in the Cuban hospital for seven days. The family had communication difficulties and asked Canadian officials for translation help, but none was provided. Global Affairs Canada told the CBC consular officials provided assistance in the case, but would release little information, citing privacy concerns.

The family turned to family and friends in Canada for help.

They spoke to doctors in Canada, who tried to help them determine what her condition was and what type of care she needed, Riley said.

They decided to fly Barb, who was still critically ill but showing signs of improvement, via air ambulance to the U.S. She was set to be flown out of Cuba on Dec. 2, destined for the Broward Medical Health Centre in Fort Lauderdale, Fla.

However, the Cuban doctors wouldn't let her go, John said. He was asked to sign a paper in Spanish that made it clear they were moving her against doctors' advice, nullifying any insurance coverage. After more phone calls and red tape, the family and air ambulance crew got approval to move her out. 

'Christmas morning was a bad one'

Over the next 10 days, while still in critical condition, Barb showed progress, John said.

However, on Dec. 20, doctors in Florida said she had developed an antibiotic-resistant pneumonia. She deteriorated even further and the family flew down to be with her for Christmas. 

"Christmas morning was a bad one," Riley said, while John fought tears. "The doctors said they didn't expect her to last more than 48 hours. She wasn't responding as well to treatments and they didn't expect her to survive." 

At that point, they decided to make sure she got home alive. Barb was flown from Florida to the Brandon Regional Health Centre on the morning of Dec. 28.

'Barb was a hell of a strong lady, and I'm sure she was gonna be damn sure she made it home.' - John Johnston, Barb Johnston's husband

"Barb was a hell of a strong lady, and I'm sure she was gonna be damn sure she made it home," John said. 

Taking a commercial flight delayed by a storm, Riley arrived in Brandon just before midnight on Dec. 28. Barb passed away one hour later, surrounded by family.

"She hung on until he got there," John said, fighting back tears.

Family members don't think they'll ever find out what first caused Barb to get sick due to the progression of her illness.

They urge others headed down to Cuba and other resort destinations to be prepared for any sort of emergency.

A way to communicate with people at home is also necessary, as dialling out from Cuba was a big challenge, Riley said. The lack of public telephones was also an issue. 

The Johnstons did have insurance for medical emergencies in Cuba but also faced tens of thousands of dollars in out-of-pocket expenses for things like flights, accommodations, phone calls and other necessities.

They are just starting to get those costs detailed and prepared. The family isn't sure how much will be covered by insurance. 

"Be prepared and get out as quick as possible if you get sick," John said. "Don't wait. Get a commercial flight or a LifeFlight out."