No Rush… and No Results

In 1953, in his self defense statement [as he appeared at his trial for the Moncada Barracks attack] History will absolve me, Fidel Castro addressed some key issues pending in our country: land reform for instance. He announced on that opportunity, as a priority in his program, giving productive land to those in possession of five or less acres; a nationalistic and democratic project that had its first episode in October, 1958, when, in the middle of the guerrilla war a bill of law was issued from La Sierra Maestra. Once he took power, actual laws were passed–on May 1959 and October 1963–in which property titles were issued to 100 thousand farmers, but 70% of productive land remained in government hands.

The new monopoly of the land and the elimination of the institutions of the civil society related to the agricultural (farming) activity generated a progressive decrease of the agricultural efficiency, while about 40% of the productive land of the country became idle; a regression that was continued until Cuba lost the subsidies from the former Soviet Union. Since then, the government had spent millions of dollars to buy food supplies that otherwise could had been produced locally.

With such an obvious deficiency of the agricultural production, just five months after taking over the presidency of the State council and of the Cabinet, General Raúl Castro, conscious of the deplorable condition of economy, expressed emphatically: We have to focus on the land! We have to get it to produce! And he added, that sooner than later laws and regulations will be passed to (once again) lease idle lands to farmers on the condition they make them productive as soon as possible.

One week after his speech, the Official Gazette of Cuba published the Decree Law 259 on that regard. This measure, could not solve such a serious problem on its own, might have been valid if this law had been conceived as the first step in a long way to go, for which a strong political will is need to face the historical problem of private property in Cuba, worsened during the Revolutionary government which promoted large state farms (collectivism). continue reading

For its content, the Decree Law 259 of July, 2008 dictated from the totalitarian optics, evaded the root of the problem. This same law was just meant to lease small pieces of land of 30 – 100 acres infected with the marabu weed, and accompanied by multiple prohibitions such as: no building of houses, warehouses or infrastructure and no hiring of employees.The absurdity was that the Decree-Law, issued to attack an inefficiency whose primary cause if the inability of the State to make the land produce, is limited to offering parcels in usufruct (a kind of leasing arrangement), that it enjoying the fruits of the work of others, while the inefficient State reserves the right to keep the property. The results obtained in these conditions aren’t what was hoped for.

However, even though the above mentioned Decree-Law lacked the power to increase agricultural production, the law itself was an implicit recognition of the need for a change. Its main fault consisted of ignoring the possession of the property in hands of the producers and keeping the economic decisions subordinated to politics. Given its unsatisfactory results and the zigzagging process without the political will required, in December, 2012, Decree-Law 259 was repealed and replaced with the Decree-Law 300.

The new regulation made some advances such as: allowed the construction of housings, stores and other facilities; also allowed farmers to hire permanent or temp workers; and let farmers lease up to 5 acres, though limited to those that already had leased contracts and were associated to official entities: State farm, and State Cooperative Farms.

Decree-Law 300 brought the same fault of the previous one, the State kept the monopoly of land and private producers subordinated to the State. In its article 11 it states that the lessees can join as workers State Farms as legal entities, or as member of a cooperative farm, for which “the lessee yields the right of the land and other infrastructure to the entity to which he joins, such entity decides whether he continues working this land or not.”

In addition, the Decree-Law 300 preserved other limitations such as inputs and services not tied to the mentioned entities, with clear disadvantages for individuals regarding the term of the contract. Such limitation revealed once again there was not a strong political will to bring agricultural production to a profitable level and a desire to avoid creating domestic entrepreneurs.

The new failure is very well adjusted to the government reforms slogan of ” no rush but not pause “, in January, 2014 Law 311 was passed, which modifies Law 300, to extend the leases to up to 150 acres to the most productive sector of the peasantry, especially to people working for state farms, that were excluded in the previous legislation. However, the lease depends on there only being credit and services cooperatives in the municipality; and b) the State farms as legal entities, basic units of cooperative production and cooperatives of agricultural production in the municipality are located at a distance exceeding three (3) miles of the requested area.

This official data does not explain the fact that after leasing 3.7 million acres of idle lands (since Decree-Law 259 was adopted in 2008), there has been reported increase in production; although there is another 2.5 million acres of land idle of the  total 15.6 million acres of potentially productive land in the country. This negative result reminds us of that phrase of Jose Marti: “Cuba has an enormous potential to become a wealthy nation, but that is impossible if Cubans cannot be wealthy as well.”

Translated by: Rafael

From Diario de Cuba

2 March 2014

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