There’s No Room, Wait Outside / Julio Cesar Alvarez

Gatehouse clinic in Central Havana. Photo courtesy of the author.

HAVANA, Cuba — Doctors working in the clinic located within the gatehouse of Central Havana Children’s Hospital refused medical treatment to a three-month-old infant named Alexander because his parents refused to comply with an internal policy of the hospital.

The policy allows only one parent to be present in an exam room. According to the doctor and nurse on duty the lack of space in the rooms is the reason for this policy.

According to Dr. Mario Lorenzo Medina, vice-director of health care at Central Havana Children’s Hospital, overcrowding in the consultation rooms was the reason why only one of the parents could be present.

“My doctors don’t have the room. They work in crowded conditions,” the director told the infant’s father. Continue reading

Hospitals, “You Are on Your Own” / Julio Cesar Alvarez

About 50,000 patients get some kind of infections annually. Lack of running water in bathrooms, clean linens, surgical gloves and even lack of brooms are among the causes.

HAVANA, Cuba. -Approximately 50,000 patients get some kind of infections in Cuban hospitals; 16,500 could die from that cause. Being admitted in a hospital is considered “more dangerous than an airline flight,” according to the World Health Organization.

More than 8 millions patients die because of a severe infections every year around the world associated to medical attention, meaning one person dies every four seconds. In the USA 1.7 million infections are reported in hospitals, causing 100 thousand deaths. In Europe, 4.7 million are also reported in hospitals with a 37 thousand death toll, according to World Health Organization.

Every year government officials in Cuba report low child mortality rates, data that  makes the Cuban Health System look great. However the numbers of infections, or deaths caused by hospital infections are not published, that could be a good indicator to measure health services quality in the island.

A hospital that has a high rate of infections among patients admitted, is not considered efficient. Even with no official data available, Dr. Rafael Nodarse Hernandez– a Microbiologist Specialist Grade 2 who works for the Dr. Luis Diaz Soto Military Hospital–confirmed in Havana that 50,000 people catch infections  every year in Cuban hospitals, as he stated to a Cuban Military Medicine magazine.

That statement was validated in a study issued by Masters in Science Luis Eugenio Valdez Garcia and Tania Leyva Miranda, from the local Hygiene, Epidemiology and Microbiology Center in Santiago de Cuba.

In an article titled “Endurance of infections associated with health services in Santiago de Cuba local hospitals,” published by the digital site Infomed, Masters Valdez Garcia and Leyva Miranda stated: “Santiago de Cuba province has an average of 2,500 to 3,000 people  that get infections in the very hospitals they are admitted to. As of 2011, reports show 2,717 events documented, meaning 2.4 cases per 100 patients released from hospitals”.

Bathroom

Bathroom at Freyre de Andrade Hospital. Photo: Julio Cesar Alvarez

Taking as reference the 33% mortality caused by hospital infections according to Master in Science Epidemiologyst Ileana Frometa Suarez, from Hermanos Ameijeiras Hospitals, mortality would be 16,500 deaths a year.

Some doctors consulted consider this rate of infections quite high, but confess they have no idea of the number of deaths caused by hospital infections, nor the exact number of people that got infected in the hospitals they work for.

Hygiene

The key element in hospital infections spreading is the environment. Hygiene is the Achilles heel of Cuban Hospitals, not only regarding surgical instruments and medical staff, but the actual hospital buildings in which patients are admitted, especially those recovering from surgery or accident victims, and those recuperating from burns.

Hygiene has declined dearly in those institutions not frequented by the government elite or tourists. Running water is not available very often in such hospitals. Patients’ relatives must collect fresh water from tanks available in the building.

That is the way they flush toilets, bathe or clean their sick relatives. Often the rooms are cleaned by relatives of patients admitted because of lack of cleaning staff or neglectful employees. Cleaning products, clean bed linen, medical gloves and cleaning equipment are very scarce in hospitals.

In addition to the poor hygiene in all institutions, infections spread mainly through health personnel; they transmit the germs when they come into contact with patients. Relatives are a source of infections as well, when acting as improvised nurses due to inefficient health services.

According to a report issued in 2010 by the American Society for Microbiology (ASM) and the American Cleaning Institute (ACI), chances of washing hands are higher in a public restroom than in a hospital. According to the World Health Organization, 60% of health professionals do not comply with the requirement to wash their hands so it is easy to get the picture on how many patients’ relatives do not comply, either because of lack of publicity or because of a non-existent hygiene culture in that regard.

With such negative picture of Hygiene in our hospitals, it is not overstated that hospital infections are one of the biggest challenges for Cuban Health System, even if government officials do not talk about it or publish actual statistics.

Calixto Garcia Hospital ER. Havana.

Cubanet, March 5th, 2014,

Translated by: Rafael

3D Movie and Video Game Rooms Going Underground / Julio Cesar Alvarez

cine-3D-composicion-300x112Havana, November 2013 – Movie and game rooms created by the private sector to stave off boredom is a sample of what can be achieved in a short time with the decentralization of the economy. The government’s recent ban on these recreational activities, shows who is holding back the changes.

What is Cinema: Art? Cultural colonization? Brainwashing? Entertainment?

Most viewers say, when asked, they are looking to be entertained, have fun, let out a few choice words when technology and ingenuity show them something surprising. At least, for many, this is the sine qua non ingredient of “the stupendous reality called cinema,” to quote Ortega y Gasset.

cine3D-cafeteria-y-video-juego-300x163On the other hand there are the the ideal comfort conditions to enjoy a movie. Most respondents mentioned an air conditioned room, comfortable chairs or armchairs, being about to snack or nibble on something while watching the movie. Some want to enjoy a drink at this moment.

These two conditions, a good time and comfort, are met in the private 3D moving rooms serving the public, although they don’t have a license to practice the activity.

Although Fernando Rojas, the Deputy Minister of Culture said on 27 October that they did not intend to prohibit this type of activity, but to regulate it, the fact is that the Cuban 3D movie room owners woke on 2 November to find their exhibitions prohibited.

sala-videojuego01“The exhibition of films, which includes 3D rooms and computer games, have never been authorized and this type of self-employment activity will cease immediately,” read the information note published by the official organ of the Central Committee of the Cuban Communist Party on Saturday, 2 November.

The owners of such rooms, such as Ronny in Vibora, hoped that the government would grant licenses to legalize them, even if they were supervised by the municipal Ministry of Culture. “I’ve invested thousands of dollars in the business. What am I supposed to do with all this equipment. How can I recover my investment?”

The House of Culture of the 10 de Octobre municipality, had among its plans to contract this type of service as activities for children. But with the new ban no one dares to talk to them about it.

“It wasn’t a bad idea. The kids love the 3D cartoons, the glasses amuse them, and they see their favorite characters in this dimension. If we managed to get some of these 3D owners to set up this kind of exchange, we can bring 3D to more kids who have few chances to go to a private function,” said a cultural promoter from the House of Culture, who preferred to remain anonymous.

The video game business

Less widespread than 3D movies, but gaining customers in parts of the city, is the video game business. The El Maravilla Technopremier, a complex technology for the self-employes, on 10 de Octubre avenue, between San Francisco and Concepcion, offers a variety of IT services, such as software installation, hardware repairs, printing and scanning, computer classes, and a modern video arcade that runs 24 hours, allowed us to take photographs, but declined to give statements.

Sala-video-Juego-de-El-Maravilla-300x225

The video game room El Maravilla, photo, Julio Cesar Alvarez photo

At a price of 20 pesos in national currency per hour, the room has networked computers to play games like Call of Duty, Word of Warcraft, FIFA, and others. It also has Xbox 360 with Kinect (Body Motion Detector) with more than 30 games in this class. Quite a deluxe set compared to what they can offer with the old software and computers at the Youth Computer Clubs.

With the new ban, the kids who currently attend these places, which are more than a few, will have one less place to play the video games they like. They will have to line up again at some Youth Computer Club to access games authorized by the”cultural politics of the government,” such as Gesta Final, a Cuban videogame that recreates the period 1956-1959, when the rebels led by Fidel fought in the hills of the Sierra Maestra.

“At the rate we are going we will have to go underground to see movies or play the games that we like,” said Juan Carlos, a 16-year-old fan of computer games.

For ordinary Cubans, the decision to ban the 3D movies and video game rooms means fewer entertainment options for a people tired of seeing what they force to watch you to see in the cinemas, falling apart from time and ineptitude.

But for the soldiers of the Cuban Ministry of Culture, a Goebbels-inspired institution responsible for ensuring the “purity and quality” of what is displayed or played with the greatest concern being “the final triumph of a mass preference for Hollywood movies that enthrone banality and trashy entertainment.”

Julio Cesar Alvarez

Cubanet, 4 November 2013

Building Collapse in Havana Leaves a Woman Trapped in the Rubble / Julio Cesar Alvarez

Escuela-pedro-Maria

Pedro Maria School this morning. Photo: Julio César Álvarez

HAVANA, Cuba, September 23, 2013, www.cubanet.org.- A partial collapse of a former school in ruins, occurred this morning in Havana, trapping a woman in the rubble, according to information from the scene of journalist Julio César Alvarez.

The Cubanet reporter says that it is the former Pedro Maria Rodriguez Elementary School, located on Calle Carmen, between Cortina and Figueroa in La Vibora, where eleven families lived. Around half past nine this morning, part of the building collapsed. At the time of this writing, rescue teams were trying to rescue the trapped body of Isabel Fernandez Gutierrez, 50. It was also learned that another local resident was hospitalized with a panic attack triggered by the crash.

The eleven families had lived for years among the ruins of the school, but had applied repeatedly to the authorities for housing.

UPDATE: In the afternoon, the family of Isabel Fernández Gutiérrez still had no news. Apparently they could not recover her body. Government officials in the area brought two trucks and a bus in order to relocate the residents to a shelter, but they remained firm: They said, or housing, or nothing. The situation was tense.

Note: Also contributing to this report was journalist Miladis Carnel Gonzalez of the Cuban Network of Community Communicators.

From Cubanet

23 September 2013

CDR: Symbol of Snitching / Julio Cesar Alvarez

CDR-vigpol-300x200HAVANA, Cuba, September, www.cubanet.org – In the same way that a blind woman with scales is an allegory of justice and a skeleton with a scythe is the allegory of death, the image that identifies the CDR should be the allegory of betrayal.

The creation of the Committees for the Defense of the Revolution in Cuba was a Machiavellian political monstrosity, conceived to reveal and suppress all forms of opposition to the nascent Communist dictatorship.

“We will establish a system of Revolutionary collective surveillance, and everyone will know who lives in the block, what those who live in the block do, what relations they had with the tyranny [of the Batista regime], where they work, who they meet, and what activities they get involved in.”

Those were the words of Fidel Castro, spoken on September 28, 1960. The apparatus of the most formidable surveillance and repression of the Communist dictatorship began to take form, implemented by the rebels in January 1959.

c646e75122cbd2e60a4639f925f1c9d518649bff-300x201The scapegoats to justify its creation were the same ones the government has used ever since: imperialism and the opposition.

“We can say that the Committees for Defense were engendered in the public square, in the midst of the struggle against imperialism, in the heat of battle and the insolent noise of the counterrevolutionary bombs,” Fidel Castro once said.

But creating such a massive apparatus of betrayal and repression could not be the work of a night of fireworks. The people of Cuba already knew well the sound of those explosions, thanks to the terrorism work of the rebels themselves led by Fidel Castro over the whole of the island to destabilize the dictatorship of Fulgencio Batista.

It was, however, a well-conceived plan and organized in the style of Hitler, to make massive political denunciation the ultimate weapon against dissent.

The CDR has been, in addition, the shock troops against opponents. Beatings, threats, psychological terror, destruction of property. Each and every one of these methods have been used systematically against active opponents.

The people’s mob, which is not all Cubans, has found in this organization an oasis of impunity to unleash their passions when they are incited against their neighbors.

Criminals and corrupt officials, however, have had better luck. The CDR doesn’t watch and betray them with the same frequency as it does the opponents. Among them and the organizations of the past there has always existed a kind of symbiosis, where many times it is the money from the crimes and corruption that have paid for the pigs’ heads and the drinks for the street parties, where they celebrate the birth of this organization.

The wood for cooking the stews burns again this September 28th on the streets of the island, like the fires of the inquisition burned the heretics. This is the 53rd birthday of a Castro regime organization dedicated to political betrayal, or as we say here in Cuba, to snitching.

By Julio Cesar Álvarez

From Cubanet

27 September 2013

Black Market is Profitable for Doctors / Julio Cesar Alvarez

HAVANA, Cuba, August www.cubanet.org. A good part of the staff in the network of Havana pharmacies, in collusion with doctors in medical offices, clinics and hospitals, sell the medications from these establishments at a premium price, as if they were private businesses.

The lines in doctors’ offices, hospitals or hospital outpatient services, coupled with the lack of doctors, who are serving on “missions” in other countries*, contribute to turning any kind of pain into a difficult problem. To get a prescription for a painkiller can be half a day’s work.

To resolve this problem, many staff at the pharmacies offer an alternative but illegal service: They sell drugs without proper prescriptions. Thus, patients avoid having to go through the doctor’s office. All they have to do is buy the medicine at a higher price.

The client

Jose Manuel, self-employed in the municipality of October 10, woke up a few days  ago with pain in the neck. Neither he nor his neighbor had any painkillers. He went to the family doctor’s office, but the doctor was “on a mission” in Venezuela. The nurse told him the new doctor hadn’t come to work. At another doctor’s office they told him they only saw pregnant women. Then he went to the pharmacy to try to negotiate for some painkillers. The clerk said that without a prescription he couldn’t supply them; however, as he knew he was a regular customer, he said he had a solution for him.

The solution for José Manuel was to pay four times the price of the drug. The blister-pack of 10 tablets of pain medication that would cost 0.70 cents in local currency with a prescription, could be had now without prescription for 5 pesos.

The clerk

According to a source who works in a Havana pharmacy (who declined to be identified), she can earn more than 150 pesos, national currency, in one day**, selling drugs without prescriptions. “The thing is not so complicated. We have doctors who supply our prescriptions. They charge us 1 Cuban currency for each prescription. That way we can sell ’under the table’ all the medicine we want, because they are backed by a medical prescription.”

She further claims that most of the clerks take the prescriptions home for family and friends to fill them out. Thus, they avoid that these documents show the handwriting of the pharmacy workers. They also try to find different doctors who sell prescriptions, so as not to repeat too much the stamp of the same doctor. Although among the doctors who engage in this activity they exchange prescription pads, so that their identity does not appear too often in the same pharmacy.

The source added that to avoid getting caught, each clerk serves a known clientele. The rest of the medicine they take home and give them to third parties to sell. A pack of 150 grams of cotton can cost $2 on the black market. A tube of Micocilén powder, $1. Creams and ointments, 10 pesos a tube. The Meprobamate blister-pack with ten pills, 10 pesos.

Another opinion

Dr. Silvia recognizes that there are patients who need medications, and find it difficult to access a prescription, for one reason or another, but she considers that the majority of consumers who access medicine in this way are those who self medicate: “There people who need to have a kit with the full range of potential drugs, and not just because they think they will be unavailable, but because today they take Duralgina for one pain, and tomorrow Ibuprofen or Paracetamol because they believe that Duralgina no longer has any effect. Some people take Meprobamate, then say they can not sleep, and there are an endless number of examples like this.”

But whatever the reasons that patients take the medications, the fact is that this market in Cuba is profitable for the white coats.

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Translator’s notes
*Doctors on missions: A main source of income to the Cuban State is the money charged for doctors and other medical personnel who are sent abroad “on missions.” The State collects many times what it pays each doctor.
**150 Cuban pesos is roughly $6.25 US, which is more than a week’s average salary in Cuba.

About the author

Julio César Álvarez López (b. 1968) Graduated in 1990 from the Hermanos Martinez Tamayo School of Counterintelligence. Arrested in 1992 for collaborating with Human Rights Groups and sentenced by a military court to 19 years, of which he served 16, seven of them in the Maximum Severity Prison of Camaguey. He was paroled in April 2008 and studied computing and digital photography at St. John Bosco church. He speaks English and is currently studying German. He lives in Havana.

From Cubanet

5 August 2013

19th Anniversary of the Massacre of the Tugboat 13 de Marzo / Julio Cesar Alvarez

Havana, Cuba, July, www.cubanet.org

The sinking of the tugboat 13 de Marzo, on the morning of July 13, 1994, with over 70 people on board, ordered by the dictatorship that governs us, does not appear in the nation’s list of anniversaries.

It is a taboo subject. It has been deleted from the official story, so they do not remember the infamy, but it is important to remember that it has been 19 years since the horrific slaughter that still remains unpunished and that those who ordered it to be perpetrated still remain in power, and now they are trying to pass the scepter to their chosen ones in order to “retire or die quietly”.

This murder has been written about many times, and many others have been read with horror. Survivors testified that they managed to cross the Morro and evade the pursuit seven miles offshore. Their captors surrounded the tug in which they were fleeing, and did them in them with their prows and water jets.

One day, without the repression of the government as a barrier, the Cuban people will go to the Malecon with flowers and remember those 41 children, women and men killed at sea in the horrendous summer of 1994.

The same way we used to remember a famous guerrilla* in elementary school. Although we did not understand why, we walked after the teachers to the nearest stretch of coast to throw flowers in the water in honor of a rebel commander** who disappeared at an uncertain point along the coast.

Teachers told us that they searched for this rebel commander by air, land and sea for many days, although it wasn’t know where his plane went down.

Even though the authorities knew from the start the exact place where, in an single onslaught, fanaticism and intolerance had sunk the ship in which 72 Cubans were fleeing the tyranny, the bones of those 41 men, women and children killed remain abandoned at the bottom of the sea.

Relatives of the victims were not allowed to bury their dead. The weak excuse that the government had no specialized divers to recover them. Perhaps what the government feared was a spontaneous and massive burial, in which the tears of a people would make injustice tremble.

Fidel Castro justified the murder in a speech: “The workers’ behavior was exemplary, you can not say it wasn’t, because they tried to stop them from stealing your boat. What can we say now, let them steal the ships, your livelihood? What will we do with those workers who do not want them to steal their boat, who undertook a truly patriotic effort, we could say, to stop them from stealing the boat? What are we going to tell them?”

Those words acquitted the murderers, and denied to the families of the victims their right to justice. Any future investigation was prohibited. Any accusation from the families fell on deaf ears in the complicit courts nationwide.

But as Fidel Castro himself said in his time, “There is always time in history to hold each person responsible for what they did.”

Meanwhile, the souls of the victims emerge daily and roam the coast of Havana, and pray that one day they can finally rest on land in an ossuary with flowers and an epitaph.

Translator’s notes:
*Che Guevara
**Camilo Cienfuegos

Friday, July 12, 2013 | By Julio Cesar Álvarez