HAVANA -- While Cubans on the street search desperately for black-market aspirin and Pepto Bismol, Fidel Castro reportedly is being treated in an ultra-exclusive Havana hospital reserved for top officials.

Roberto Ortega, who served for 10 years as chief of medical services for the Cuban armed forces until he defected in 2003, believes Castro is being treated within a special medical compound in the Kohly neighborhood that's an enclave for the highest members of the government.

"It's like a spa with a lot of security," Ortega said.

Scholars at the University of Miami's Institute for Cuban and Cuban-American Affairs also have sources saying Castro is at the exclusive hospital, but it might be near one of his homes in the Havana suburbs. A less-likely possibility is CIMEQ, a Havana facility serving top military officers and foreigners with dollars.

The Cuban government is not saying where Castro is, and no medical personnel are known to be leaking the news -- perhaps discouraged by the Tuesday pronouncement that Castro's health is a matter of "state security." That means anyone who reveals details about Castro's situation is committing high treason, which could be punishable by death.

Still, wherever he's being treated, experts say it's clear that Castro is receiving top treatment while regular people on the island struggle for bare medical necessities.

Jose, 54, a retired coach in Havana whose son in Miami sends him medicines with friends and relatives who travel to the island, says there's a huge black market for things as basic as Advil and Extra-Strength Tylenol. "I can't keep them for much longer than a week," said Jose, who didn't want to give his last name.

Hilda Molina, a brain surgeon in Havana, said the black market now includes physician services. "The doctors in the hospitals are charging patients under the table for better or quicker service," she said. She knows people who pay $50 or $60 for X-rays.

Molina, who once headed Cuba's National Center for Neurological Restoration, broke with the regime about 12 years ago after she was denied permission to travel to Argentina to visit her son.

"It's very difficult to get any kind of medicine here," Molina said Thursday in a telephone interview from her Havana home. "One tablet of meprobamate, a muscle relaxant, goes for between $1 and $5 in the Cuban convertible currency. That's not for a bottle. That's for one tablet."

Official statistics indicate that by one measure -- life expectancy -- Cuba is doing quite well: The average Cuban male lives 75.2 years, compared to the American male's 74.5.

But Juan A. Asensio, a trauma surgeon at the University of Miami and a Cuban-American who has studied the island's medical system, questions first whether such figures can be trusted. What's more, Cubans may be helped more by the simplicity of their lifestyle than their medical care. "No McDonald's and Cubans walk everywhere or ride bikes because they can't afford cars."

Meanwhile, Ortega believes Castro probably is being treated in a medical compound on Calle 49 near the Almendares River -- in the Kohly area reserved for members of the Politburo and other extremely high officials in the government.

"It is very exclusive, with every possible service," said Ortega. The compound, in a residential neighborhood, has converted mansions into clinics for dentistry and other needs, and added a large building for high-tech surgery and intensive care.

"It's like a luxury hotel," said Ortega. "It has a cafeteria, a restaurant, a pool, saunas, physical therapy offices." Those who work there are either members of the interior ministry or they have been checked and approved by Cuban intelligence.

The other highly exclusive hospital is CIMEQ -- the Center for Investigations of Medical Surgeries -- which has a Web site intended to lure foreigners, saying it is known internationally as "an institution in the vanguard of technology," using advanced lasers for gastroenterology, among other things.

Started in 1982 in the Siboney neighborhood, the hospital says its rooms are designed for the "maximum comfort of the patients and companions." Foreigners can also rent residences in the area and go to restaurants offering "cuisine of the highest quality," the Web site says.

Ortega says a floor at CIMEQ is reserved for the use of Fidel and his brother Raul, but the Kohly facility is newer and more secure -- and that is the most likely place to treat them.

Andy Gomez, a scholar at UM's Cuban Institute, agrees that it's unlikely that Castro is at a facility that serves foreigners. "There are no tourists there," said Gomez of Castro's exclusive hospital. "You and I cannot go in there, even with dollars."

Jaime Suchlicki, director of the UM institute, said that, while the Communist-run government in Cuba may boast of free and universal health care, it practices medical apartheid.

"There are three tiers of hospitals in Cuba. One is for the average Cuban, which is lousy, has very poor facilities, poor medication and so forth," said Suchlicki, who said he is in regular contact with doctors on the island. "The second one is the one for tourists and medical tourism, where there is very good equipment. The third is for high government officials and they are also very good."

This story appeared in The Daily Herald on page A8.