Category: Bertha Guillen

Since 2015, the deficit of drugs has worsened due to the country’s lack of liquidity. The Biotechnology and Pharmaceutical Industry Group (BioCubaFarma) attributes the problems to the shortages of raw material due to the long-standing non-payment of foreign suppliers.

“We did not have the necessary financing to pay the debts incurred,” Teresita Rodríguez Cabrera, vice president of the group, told the official press in late 2016. The official said that the industry was working to improve supply, but a year later the situation has worsened.

“Six months ago we had 97 drugs missing at this pharmacy,” says an employee of the Candelaria dispensary who prefers anonymity. “In the last three months the figure has reached an alarming number and we are now lacking 157.”

According to this source, analgesics, hypertension pills, diabetes pills, antibiotics and eye drops are among the most affected, “precisely because they are the most in demand.” The employee says that the managers of the branch assured them that the situation would normalize as of September, but the expected return to normal has not materialized.

“As of today, only a few drugs have arrived and in insufficient quantities,” the employee emphasizes.

The medications sold on presentation of a control card, known as a tarjetón,

are among those in shortest supply. The State subsidizes all pharmaceutical products and regulates the quantities that each consumer can buy, even when it comes to medications that don’t require a prescription.

In the small villages near Candelaria several pharmacies have closed their doors permanently due to the lack of supply, which overloads the dispensaries that remain in operation.

The administration of the Municipal Main Pharmacy has taken measures to avoid the crowds that form when supplies arrive. These guidelines also seek to curb the hoarding of products, many of which end up on the black market.

This Wednesday, outside the pharmacy a hive of customers tried to reach the counter, screaming and shoving. In a near brawl won by the strongest, people with disabilities, pregnant women and the elderly had to retreat to avoid getting elbowed.

The pharmacy workers responded by closing the place down and calling the police to restore order. Buyers who clustered at the small window to ask questions also received no response and for hours no employee picked up the phone.

The pharmacy administration is determined to sell only one prescription of each drug per person, a decision that bothered those like Milagros, 64, who stood in line from nine o’clock on Tuesday night and had hoped to receive enough medication to last until the next supplies came in.

A few blocks away, the Catholic church also lacks the supplies to meet the demand for medicines. For several years the parishes have supplied the needy with non-prescription products that come from donations from abroad. In the last half year, however, the arrival of these donations has also declined.

“For months we’ve gotten nothing more than vitamins and some other things and those only in small quantities,” Olimpia, the women in charge of drug distribution at the Artemis church, tells 14ymedio. Hurricane Irma has affected many provinces of the country, causing much of the aid to be channeled to those areas.

In these circumstances, many Candelarians settle for trying to relieve their skin itches or lower their blood pressure through the traditional infusions that their grandmothers abandoned years ago.

However, the sector is seriously affected by the desertions of professionals during their missions abroad and the exodus towards other better-paid economic spheres such as self-employment or tourism, of doctors who remain on the island. In addition, physicians must deal with long work hours, material deficiencies and the dissatisfactions of patients.

Since the beginning of this year the doctors have been able to buy laptops in the store for public health workers in the provincial capital. The offer has brought long lines outside the premises and complaints about the capabilities of the equipment.

Since the beginning of these sales, an indeterminate number of laptops has ended up in the informal market, where they are sold for a price ranging between 200 and 300 CUC, between eight and 12 times the original cost.

Recently the official newspaper Granma revealed that each year Cuba collects more than 8.2 billion CUC (roughly the same in dollars) for “the export of health services.”

This month, several meetings in the province of Artemisa notified staff working in polyclinics, hospitals and other health centers that only doctors are entitled to acquire these computers. X-ray technicians, lab workers, and even dental graduates “are not included in this offering,” ministerial authorities said.

The information has generated a barrage of criticism and discontent among dentists and other professionals in the sector. None of them, except graduates in medical sciences, will have access to the merchandise sold in stores authorized for public health personnel. Among these products are also the white coats that are currently distributed on a staggered schedule in Artemisa province.

“This has gone beyond a lack of respect,” said the dentist from Candelaria. “Now it turns out that we are not the same as doctors, but when it comes time to participate in acts of repudiation against the words of Donald Trump, we are.”

Raiza Machín, a dentist from the province, does not speak half-heartedly. “I feel offended, even the self-employed who work in coffee shops wear white coats, how is it possible that as a public health worker we cannot buy them in a store dedicated to us?” asks the professional.

According to the head of the Public Health Workers Union in Candelaria, the information came from the Ministry itself and applies to the whole country. In response to the workers’ discontent, the union representative demanded a meeting with “the highest authority” but has not yet received a response. “For the moment we are not doctors and therefore we can not use the same facilities as they can,” says Machin sarcastically.

“At first they told us that they had to wait until they finished distributing the laptops among the doctors in the hospitals, then it would be the clinics’ turn, and then finally our turn,” says Araceli, a dentist with several years of experience.

“They have strung us along and now that say that we are not doctors, that’s why we don’t get the computers,” complains the dentist. The refusal to allow dentists to buy them became known shortly after the official media assured that the dentists were “guaranteed” laptops.

“Since our title says ‘Doctor of Dentistry’ I have to consider that I am one,” Machín stresses.

“I get up at three in the morning for the milking in the dairy,” says Senén, Roberto’s father and a resident of Artemisa province. “When we have the milk that fulfills what we have to give to comply with the state plan, then my wife makes the cheese with what remains.”

Each farmer is obliged to sell most of their meat and milk production to companies and state centers

Each farmer is obliged to sell most of their meat and milk production to companies and state centers. In 2015 the price paid to the farmers for this fresh milk rose from 2.40 Cuban pesos (CUP) per liter to 4.50, less than half of the 10 CUPs (about 40 cents US) that it sells for in the informal market.

Private producers are prohibited from selling milk or any dairy product they produce to other private individuals on their own. However, many homes and private restaurants throughout the island are nourished by this artisanal food, made and transported under absolute discretion.

“My family has been making cheese for years,” Senén explains at midday. They started making it during the Special Period when all the clandestine pizzas were made with the so-called guajiro cheese. Now some private restaurants buy pieces of gouda or Parmesan in state stores or on the black market, but artisanal production remains the most affordable for domestic customers.

A few miles from the house of Roberto and Senén, in the dairies of Cayajabos, Olga begins to cut the milk with a serum made from pork lungs and lemon. This technique ensures a consistent and good tasting cheese. She adds some boiling water “to kill the bacteria” and to achieve a firm, “gummy” texture.

Cuba is experiencing the worst drought of the last half century and the country’s reservoirs are below 39% of their capacity

Today Olga wants to make a piece of about two pounds with ten liters of milk. “At the moment we are making few cheeses because the cows are giving very little milk and we have to fulfill the plan,” she says while straining the fermented milk and recycling the serum to use it again.

Cuba is experiencing the worst drought of the last half century and the country’s reservoirs are below 39% of their capacity. More than 81% of the agricultural area is affected by low water levels in irrigation and the effect on livestock production is especially negative.

Rain is not the only problem. Along with the 120 liters of water a day a cow drinks, it also consumes 10% of its weight in pasture grass, fodder and food concentrate, according to experts consulted by this newspaper.

Grasslands are currently dry and the feed supply is unstable. Farmers juggle feeding their cows with mixtures that also include derivatives from the sugar industry. The deficit directly influences the amount of meat and milk that is produced.

According to Rogelio González, a farmer from Cayajabos, 30 years ago a dairy was capable of producing up to 2,160 liters of milk daily, while now among the 10 dairy farms in the area, they barely reach the 1,080 liters needed to comply with the state plan.

“We had here the trays loaded with feed and purge honey, there were areas of fodder, urea, salt and the milking system was mechanized, all this helped to a improve production,” evokes Gonzalez. “But then everything got destroyed, the grazing fields are surrounded by the invasive marabou weed and the milking systems are pitiful.”

During the years of the Soviet subsidy, Cuba managed to produce up to 200 types of cheese, but the fall of the Socialist Camp ruined production and paralyzed the most important industries in the sector. The authorities are trying to revitalize some of the dairy processing plants, but without foreign investment the project becomes very difficult.

While state production tries to pick up the pace, Senén continues to make progress in artisanal cheese production. All around are small wooden molds made with bits of planks of different sizes to give shape to the cheese. The press that extracts the liquid is used before the work of turning.

Under the structure, a white bucket collects the liquid that is draining. “This is to feed the piglet I have back there,” adds the dairy farmer. “You have to take advantage of everything.”

When the process of pressing is finished “you have to refrigerate the cheese for a few hours so the crown has a nice yellow color and a better texture,” according to Senén.

“Right now, we are making only two kinds of cheese, not only because of the lack of milk but also because there’s not a great cheese culture here, so they eat the artisanal cheeses and the so-called processed cheese, which is sold in the little market for Cuban pesos, and in the store there is only gouda and it’s very expensive,” he says. A pound of the latter cost between 9 and 10 times more than the product made by Senén and his family.

Among the handcrafted products is the so-called guajiro cheese, which is sold on the highway

Among the handcrafted products is the so-called guajiro cheese, which is sold on the highway. Normally it is made from skimmed milk boiled and cut with piña de ratón, a wild seed. The result is a product that is white and more grainy.

To supply the private restaurants specializing in Italian food the process becomes longer and complex, in order to cure the cheese better. There are customers who prefer it with salt and others without salt, details the farmer. It should be avoided at all costs that the milk gets smoky during the cooking.

“We have to take the risk of selling it in Havana, because there they pay better.” A pound trades in the informal networks for between 25 and 35 CUP depending on the curing of the product. “We are making contacts and fixed points where they buy from us,” says Roberto, who fears fines and arrests on the highway.

“Every day the police get more strict and if they catch me, they remove the merchandise and take me to the station”, says the young man. More than once he has had to run and abandon the product. “It’s hard work, sometimes I only sell a little and most of the time is in the sun.” For him, the best days are those when some foreigner arrives.

For travelers passing by in their tourist cars the scene always looks nice and with an air of tradition: a man on the side of the road holds a cheese in his hands, as a trophy, while ensuring that it is “home-made.” Few realize the difficulties associated with trying to sell this delicious food in Cuba.

Rosario’s competition is strong, and he must add new options and products to make his offerings more attractive. At the end of February there were some 539,952 people with self-employment licenses. Of these, 59,700 are engaged in preparing and selling food.

The group keeps tabs on patron saint parties, carnivals or any local festival. They arrive at the place and set up their improvised stands

The license to engage in this occupation allows the seller to move from one municipality to another and also between provinces. “I had some neighbors who were involved in this business and I realized that it was worth it. So I threw myself into it,” Rosario tells 14ymedio.

This man from Pinar del Rio is part of a group that keeps tabs on patron saint parties, carnivals, or any kind of local festival. They arrive at the place and set up their improvised stands, made out of the same metal cots they sleep on at night.

The merchants go from here to there and spend the greatest part of their time on the highways, roads and public plazas. Some of them don’t even have homes and choose the traveling business without ties to any place they can return to. They are this century’s nomads, in a country that has a housing deficit of 600,000 units.

“At the beginning it was a little complicated, because my previous life was so peaceful,” says Rosario. The state café where he worked was known as “the king of the flies” because it had very few products and even fewer customers. He then took a risky step and now he is used to the “festive atmosphere and the crowds of people.”

In a nearby timbiriche – the Cuban word for a tiny commercial stand – is Yaumara, a jewelry seller born in Bahia Honda. She displays necklaces, rings for all sizes, and jewelry made from surgical steel, very popular among those who can’t afford gold or silver.

“I always liked a party,” the merchant confesses, so her current job “is easier” for her.

When the swarm of vendors arrive in a town they register at the municipal Physical Planning Office. They rent a space for their flea market and show their licenses from the National Tax Administration Office (ONAT), which allows them to engage in activities ranging from the sale of good to the management of children’s games.

They take care of each other and warn of possible police controls. When an inspector demands they report on a colleague, everyone remains silent

Among the sellers bonds of friendship and family are created. In the caravan there are several married couples and some have even found love along the road. They take care of each other and warn of possible police controls. When an inspector demands they report on a colleague, everyone remains silent.

Despite the restrictions on selling imported merchandise, many products sold at the fairs come from Panama, Russia or the United States. What they display openly is only a small part of what they have on offer. “Here we have something for every taste and pocketbook,” says a home-appliance salesman who also offers light hardware.

Another part of the merchandise comes from the network of hard currency stores managed by the State. In towns where shortages are a much more chronic problem than in provincial capitals, resale has become a widespread practice. The merchants supply sponges for scrubbing, pens, flip-flops and belts.

“We sell at retail and that’s good because there are people who can’t afford a packet of detergent but can buy the small bags we repackage it into,” says Maurilio, who has spent at least five years “in these comings and goings.”

The group evaluates how long to stay in each village. “We see how things are, the atmosphere of partying and how sales go on the first day, then we decide whether to stay or not,” clarifies the entrepreneur.

Most of the inhabitants of the hamlets and settlements welcome them. “I look forward to the fair because it is an opportunity to buy things for the house and also my children love it,” says a resident of Candelaria. However, some residents closer to the points of sale complain that the travelers sleep on porches or take care of their personal needs in the street.

Some residents closer to the points of sale complain that the travelers sleep on the porches or take care of their ‘personal needs’ in the street

Ernesto and Uvisneido have solved that problem. Coming from the distant city of Guantánamo, they entered the business with a supply of toy cars. With the profits they bought a small trailer with three bunk beds and a bathroom. “So we do not have to sleep outdoors,” says Ernesto.

“We also have a dragon toy, a small inflatable jumping structure and a swinging chair carnival-type ride,” he adds. His customers are children who pay about 5 Cuban pesos for each turn on the ride or for a few minutes of jumping on the inflatable.

“There is always some inspector who spoils the party, but with this work we make out,” says Ernesto. Traders who have not managed to get a trailer to sleep in at night, set up their cots anywhere and pay a guard to patrol the vicinity.

With the first rays of the sun, they need to begin to proclaim their products or undertake the journey to the next town. Trade nomads know that their business only works if they travel everywhere.

“My salary is 1,295 CUP from which they deduct 5% for the payment of social security and any other invention that arises, which leaves me approximately 1,240 CUP,” Rodriguez told this newspaper. The health professional estimates the cost of the laptop to be “more than half” of his monthly salary.

The approximate take-home pay of doctors is around 1,240 Cuban pesos, meaning the subsidized the laptop costs more than half a month’s salary

Nevertheless, in spite of the juggling he has to do to make ends meet with the new expense, Rodriguez is content. “It’s about time they remembered us,” he says, referring to the medical profession.

Cuban Public Health employs a total of 262,764 people, of whom 87,982 are doctors, according to data from the 2015 Statistical Yearbook.

The doctors earn the highest wages in the country, equivalent to a total of between 50 and 70 dollars per month, but also have to deal daily with a working day marked by very long hours, the material deficiencies that affect the hospitals, and the dissatisfaction of their patients.

In Artemis, the physicians can acquire a laptop at a store that caters to public health workers, located in the provincial capital, a situation that has led to long lines outside the premises, where impatience mixes with the desire to obtain the desired piece of technology as soon as possible.

The store’s administrator, Roberto Gallardo, told the provincial newspaper, El Artemiseño, that “once the sale of the laptops is concluded,” there will be offerings for “uniformed nurses, lifeguards, anti-mosquito campaigners and physiotherapists.”

Gallardo, who works for the Provincial Logistics Company (Epola), said they are trying to pay more attention to health care workers and so among the things that might be offered are, “home appliances, and supplies for personal grooming and the home.”

One of the workers from the store told 14ymedio that the sale of computers will continue throughout January, although they initially planned to end it in the first half of the month. “So far we have sold, in Artemisa, San Cristóbal, Candelaria and Guanajay, but we still have towns to cover,” explains the employee.

“We started with the hospitals and then the doctors in the clinics, which is a large number,” said the employee, who preferred to remain anonymous.

The computers distributed are mostly ASUS brand, from Taiwan, and have a two-year warranty, but only on condition that the user does not change the version of the Microsoft Windows operating system that comes with the computer.

The price of one of those notebooks in the informal market is between 200 and 300 Cuban convertible pesos (equivalent to about the same in dollars), so some doctors are not waiting to resell them to get cash, and others to buy a machine with better features.

Rubén, a computer engineer in the area, points out that other little-known brands are also being sold. In his opinion, “the computers are only a token,” because the quality is not good and he considers the integrated battery a limitation, since it makes it difficult to replace it in case of damages.

The price of one of these laptops in the informal market oscillates between 200 and 300 CUC, so some doctors aren’t waiting to resell them for cash

Ana, a doctor in the provincial hospital is not satisfied. “We Cuban doctors are accustomed to surviving from the charity and gratitude of our patients,” she complains. “The bad conditions under which we work are a secret to no one.”

Nor is she satisfied with the quality of the computer compared to “the millions of dollars the Government earns through the sale of medical services abroad.” The official Granma newspaper itself has revealed that each year Cuba collects more than 8.2 billion CUC (roughly equivalent to the same in dollars) through “exporting health services.”

Roberto, another doctor in Artemisa, does not share the opinion of his colleague. “I’m happy with mine, and I can connect via Wi-Fi,” he tells this newspaper. “Maybe the machine is not the best, but it’s cheaper than you can buy on the street, and anyway, I didn’t have one,” he enthused.

However, the physician is more cautious about the other possible benefits announced for the sector. “The story that they are going to give us access to the internet is a trap.” He also distrusts being the idea that he will be able to obtain an affordable car and sees it as something unattainable “for those who have to go to work every day on a bicycle.”