Translator: Cristina Saavedra

Cuba’ Healthcare: ‘As Medical Students, We Have to Clean Bathrooms and Change Lightbulbs’

A shortage of staff in Cienfuegos’s hospitals requires future doctors to do it all.

The Ministry of Public Health and Social Welfare lost 44,200 workers between 2022 and 2023, according to the latest yearbook. /14ymedio

14ymedio, Julio César Contreras, Cienfuegos, January 30, 2025 — When Lisbeth arrived at Paquito González Cueto pediatric hospital, toughened by her tenure at various polyclinics in Cienfuegos, she thought nothing in the Cuban health system could surprise her. A third-year medical student, she hoped, that one of the most prestigious institutions in the region would offer her a less harsh outlook, than that of other centers where she had completed her internship.

However, as a result of the drop in population, the lack of personnel is felt more acutely in the state sector with salaries that pale by comparison to those in private industry, and even more so in the health field, where the human factor requires an extra effort that isn’t rewarded at the end of the month. Public Health and Social Welfare has lost 44,200 workers between 2022 and 2023, according to the latest yearbook, published this year.

Of these, at least 32,000 are doctors, but the shortages are intersecting and student interns not only solve the shortage of doctors, but also resolve tasks for which they are overqualified.

Of those, at least 32,000 are doctors, but the shortages are intersecting and in practice the students not only make up for the lack of physicians but must also carry out tasks for which they are overqualified. continue reading

“During my shifts, I have escorted patients in wheelchairs and on stretchers. I’ve had to administer injections and even had to sweep the floor.

“During my shifts, I have escorted patients in wheelchairs and on stretchers. I’ve had to administer injections and even had to sweep the floor when no one else is taking responsibility for cleaning,” informs Lisbeth, who also cautions about a long-standing issue. Not only must the patients bring their own food if they expect to receive adequate nourishment, but so must the doctors, as she herself has during the months of her internship.

Unlike doctors or other health care providers, medical students cannot ask for leave or a transfer to another hospital if they don’t like where they are. Doing so could cost them their diploma or result in a serious reprimand. The obligation to remain wherever they’re sent also subjects them to excessive workloads and arbitrary orders from those in charge.

“Sometimes, after I’ve finished my shift, I can’t leave to go home and sleep, have a coffee or take a shower,” another young student interning at the University General Hospital Dr. Gustavo Aldereguía Lima told us. “As students we’re at the bottom of the pecking order; we’re asked to do everything from carrying buckets of water from the cistern to picking up food for the doctors.”

Lisbeth accuses her professional colleagues of trading patients for “bags of food and necessities.” / 14ymedio

Instead of encountering professional challenges that would help him grow, the young student has had to clean bathrooms, climb on chairs to fix a suspended ceiling so it doesn’t fall on a patient’s bed, or bring light bulbs from home so he can use the bathroom at daybreak. “Sometimes I think I’m going to graduate as a repair technician instead of as a doctor.”

For her part, Lisbeth accuses her professional colleagues of trading patients for “bags of food and necessities.” “It’s as if they are indifferent to the suffering of others,” she states. “If they have a case, they will prioritize those who are ‘recommended,’ those that have ‘clout’ or bring gifts,” she complains.

“When we are treating a patient, I’ve also noticed that some of our professors merely indicate a clinical procedure without explaining to us the cause of the illness and the reasons for their decision. We are practically doing the job of the nurses, basically learning through the literature, which is at times outdated,” she explains. “Some of my classmates ask me to be less combative, saying we just have to pass our exams, but I’m not satisfied with that.”

Lisbeth has a few more weeks left to finish her rotation at Paquito González Cueto, with its crumbling physical structure that serves as a metaphor for what is happening within its walls. Her greatest fear is that a truly ill patient will come in, a child whose treatment will not abide tricks or improvisations. “How can I provide the family of that child with assurances that the child will receive the highest standard of care?” she asks herself.

With a vocation for medicine since her childhood, the young student sums up the tragedy of studying medicine with this observation: Her profession is a noble one, but she was destined to pursue it in the wrong country.

Translated by Cristina Saavedra

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In the Absence of Buses and Fuel, Horse-Drawn Carriages Provide Transportation in Cienfuegos, Cuba

Much cheaper than tricycles and scooters, cart drivers do not enjoy the sympathy of the authorities

When the law leans on them, carriage drivers find a way to survive. / 14ymedio

14ymedio, Julio César Contreras, Cienfuegos, 19 January 2025 – “State-run busses are no competition for us, because they are virtually non-existent,” gibes a driver waiting to load his horse-drawn carriage precisely where La Calzada de Dolores in Cienfuegos begins. Although the area designated by the government for pick-up, far from the downtown, has become a dumpsite of animal urine and feces, people are not dissuaded from climbing on board the rickety carriages to go anywhere in the city.

“We would welcome a better location. People in El Prado, for example, who’re going to Tulipán need to walk at least ten blocks to get here through El Parque Villuendas,” explains Jorge, who’s been driving his carriage for eighteen years.

These drivers report that, far from providing the opportunities they seek, the local authorities have been “on the verge of wiping out the carriages entirely.” Jorge is grateful that each time those measures have been about to take effect, the fuel crisis and the scarcity of buses have tipped the balance in favor of the carriage drivers. Nonetheless, the government’s stance remains hostile.

“The only thing left for Party leaders to do is blame us for causing an epidemic. Together with Community Services and the Ministry of Labor, they have changed our routes, raised our taxes, controlled our prices—all with the goal of making us gradually disappear,” he stated.

When the law leans on them, says the man, the horse-carriage drivers find a way to survive. What’s most common, he affirms as he turns the queue over to a colleague who had just arrived at La Calzada, is renting the vehicle. “Whenever we can, we have to rent out the carriage; it’s the only way we can afford to pay the tax authorities, maintain the carriage, and take care of the horse,” he affirms. But since so many are doing the same thing, it’s not easy to get more than three or four rentals per week. continue reading

Jorge also bemoans the fact that the horse-carriage routes are not as flexible as those of the three-wheelers and motorcycles.

Jorge also bemoans the fact that the horse-carriage routes are not as flexible as those of the three-wheelers and motorcycles, which also offer trips downtown. But the driver knows that compared to motorized vehicles, his trade has an advantage: the prices. “Not everyone can rent a scooter to La Juanita or Junco Sur, because they can easily be charged 1,000 pesos for the trip,” he estimates.

Osmani, the young driver to whom Jorge gave the last one, almost completely agrees with the man who has become a kind of mentor in the trade to him. “Lots of people complain that our routes are limited, but we know we aren’t the ones to blame.”

It’s been seven months since the young man began the process of finally putting his carriage in circulation. “Instead of making things easier, they put up bureaucratic roadblocks that would discourage anyone. And after overcoming the initial hurdles, then the daily struggle begins with the inspectors who are ready to issue fines even for the animal’s excrement,” he complained.

At the pick-up spot, time is money. That’s why the drivers try to fill the carriages quickly, and when they can’t, the clients become impatient. “When they say they’re going to the stop at the Provincial Hospital or the bus terminal, they really stop two or three blocks before. It’s not the drivers’ fault they can’t go all the way there, but we are paying for a trip that is never completed,” bemoans Idania from the seat of one of the carriages waiting to be filled. “When I get off, I still have to take another means of transportation to get to my house in the Reina neighborhood.”

At the pick-up spot, time is money. That’s why the drivers try to fill the carriages quickly. 14ymedio

With 20 pesos for the trip in hand, Idania attempts a brief analysis of the problem with transportation in the city. Her conclusions aren’t good: There are no buses; alternative forms of transportation are expensive; and the cheapest, like the horse-drawn carriages, don’t cover all the routes they could.

The woman also dislikes the idea that hundreds of Cienfuegos’s residents rely on animal-drawn transport daily. “Obviously, I am in favor of protecting animals, but in our country, you can’t dispense with this form of transportation.” With the carriage now full and ready to leave, Idania winds up the conversation with a truism with which the rest of the passengers concur: “If it weren’t for the horses, we’d have to cover the entire city on foot.”

Translated by Cristina Saavedra

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The Family of José Daniel Ferrer Declares It Has Not Heard from the Political Prisoner in Two Months

José Daniel Ferrer, leader of UNPACU, imprisoned in Santiago de Cuba, in an archived photo (Screen capture).

14ymedio, Havana, 13 May 2023 The Cuban regime remains unyielding with the family of the political prisoner José Daniel Ferrer, leader of the Patriotic Union of Cuba (UNPACU), who for the last two months has been denied visits from his wife Nelva Ismarays Ortega Tamayo. After a failed attempt to see him on May 11, Ortega called on the international community and people of goodwill to speak out against the violation of human rights on the island.

In an audio recording shared with the independent press, Ortega Tamayo explained that she travelled to the maximum security prison in Mar Verde on Thursday for a conjugal visit. While in the waiting room, however, she was informed by the Head of Internal Security that she would not be allowed inside.

Ferrer’s wife said that no family member has had direct contact with him since March 14. Since then, the political leader has been incommunicado under an “enforced disappearance” and deprived of the right to a legal defense. “The last time his children Fátima Victoria and our little one Daniel José, only three years old, were able to talk to their father was last March 7, a day after the dictatorship gave him the right to a phone call for the last time,” she stated.

Ferrer is one of more than 1,000 political prisoners that the Cuban regime is holding in its prisons since the massive protests on July 11, 2021, in addition to detainees from demonstrations in recent months. During these almost two years, his family has reported on various occasions that the prisoner has been the victim of torture, beatings and threats. continue reading

The opposition leader has been in the same dungeon “isolated and confined since August 14, 2021,” his wife added, in order to break his fighting spirit. “He is probably seminude, under the same deplorable, inhumane, cruel and degading conditions, subject to mistreatment and torture, both physical and psychological,” she indicated in her report.

Ortega recalled that Ferrer also does not have access to his medication, another violation of his basic rights. This causes “uncertainty and pain for the whole family,” added his wife, who affirmed they will continue to demand peacefully from the dictators Miguel Díaz-Canel and Raúl Castro “signs of life from José Daniel. You are ultimately responsible for his physical and psychological well-being,” she said.

Ortega indicated that the government expects Ferrer accept exile from Cuba, in spite of “knowing very well that he would rather die than abandon his homeland.”

Translated by Cristina Saavedra

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More Lost Than Columbus

Map of the Island with the description “Terra de Cvba-Asie partis,” which means “Land of Cuba— A Part of Asia” (US Library of Congress)

14ymedio, Yunior García Aguilera, Madrid, 9 May 2023 — Our history classes, with few exceptions, were insufferable. They hammered our brains with the Marxist view that, from the time of the aboriginal people up to the bearded cacique, the history of Cuba was limited to the struggle of the working class to create communism. Our exams were reduced to organizing events chronologically, coming up with adjectives for our heroes, repeating by heart dates and slogans. I tip my hat to those teachers and historians who come out of that system, but to be sure, they are like gold nuggets at the bottom of a river.

It’s shameful that so many college students have no idea what distinguished the Taino people from the Ciboney, or can’t name more than two presidents from the republican era. What’s worse, these last decades have been a wash, drowned in censorship and propaganda. In this column, I will try to approach, as a curious, avid reader, the hidden story of an island that was first named Juana and later Fernandina.

“History Without Hysteria” originated as a segment that lasted two seasons on the Cuban podcast El Enjambre. I invite you to debate, dissent, add information and anecdotes. Let us make our history a recurrent theme in our daily conversations, so that it is not confined to academic circles.

I’ll start off with Columbus, a figure so misunderstood that even he never knew what he had “discovered.” I begin with him, because he was the first to write down the name of our land, although he did it incorrectly. Without a clue as to what the Lucayans were telling him about a large, rich island to the south, the Admiral wrote in his diary a mysterious name: Colba. continue reading

Upon reaching land, probably at what is today Bariay, he stated that well-known phrase about “the most beautiful land,” etc. But let’s not get carried away with vanity. Columbus had been travelling for more than two months surrounded by water everywhere and with a crew that was about to throw him overboard. The Admiral would see a bird and sigh; a blade of grass would make his eyes water. All the hyperbole and metaphors were meant to raise the morale of the men and reassure the kings they had invested their two million maravedis well.

Another theory states that the first landing in Cuba was in Puerto Padre. In fact, there is a legend that a sailor exclaimed to a priest: “What a port, padre!” But no, friends of Las Tunas, despite all the paintings that depict a priest with a cross at the landing, there was no priest aboard the two caravels, nor on the ship Santa María.

Christopher Columbus, whose name in Genoese means something like “the dove of Christ,” had made his living as a sailor and a vendor of maps, until he found a more ambitious project: going left to reach the Indies. Fortunately, he did believe that the world was round, not like the millions of people who today still believe it is flat. But his calculations were incorrect. The terrestrial sphere was about four times larger than he and others of his age believed.

Even so, upon landing in Cuba, he assumed that he had finally reached Cipango, the name the Europeans then used for Japan. On top of that, the Admiral asked where he could find the great Khan, and the Taino answered, “Cubanacán, Cubanacán.” The Admiral was overwhelmed by the throng in hides and racoons, although his steadfast objective was the gold. He did not see much, however, but for the occasional ornament in the form of snot hanging from their noses.

On his second voyage, Columbus attempted to circumnavigate Cuba by going south, but he gave up before he reached the western end. He then rectified the assessment made on his first voyage: Juana was not an island, but the mainland. The Admiral understood that he was not in Cipango, but in Catay (China). And he made his men swear to it, on pain of losing their tongues.

Today, more than five centuries later, many are still clueless. Sadly, a lot of people still have a romantic and childish vision of us, with no idea about the country pulsating beneath Castro’s propaganda, the tourist ads, and the ideological banners. For all those suffering from Columbus syndrome, there’s a very native expression: “Wake up, we’re in Cuba!”

Translated by Cristina Saavedra

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Three Blows to the Agreement for Political Dialogue and Cooperation Between Cuba and the EU / Dimas Castellano

Dimas Castellano, 7 July 2021 — The democratization of Cuba, a Western country laboring under a totalitarian government in the twenty-first century, is an urgent necessity. Cubans, who lack the space and freedom to participate as agents of that change, require international support. After 25 years of mutual relations, the European Union (EU) has shown the requisite conditions to satisfy that role as a partner.

The European Economic Community (EEC) was created in 1957 by Belgium, France, Italy, Luxemburg, the Netherlands, and West Germany. With the signing of the Maastricht Treaty after more than three decades in development, it added political ties to its economic relations and went on to be named the European Community (EC). At the summit meeting of the heads of state or governments of the member countries, it then became the EU.

In 1996, the EU, whose members maintained bilateral relations with Cuba, assumed a Common Position with the objective of “fostering a transition to democracy and respect for human rights and fundamental freedoms, as well as a sustainable recovery and an improvement of living standards for the Cuban people.”

A retrospective view of 25 years of relations with Cuba bears this out.

In 2002, Cuba sought to be incorporated into the Cotonou Agreement, a cooperation agreement between the EU and countries of Africa, the Caribbean, and the Pacific, in which the parties are obligated to respect human rights and fundamental liberties.

In 2003, as the application was about to be approved, the imprisonment of 75 peaceful combatants and the execution by firing squad of three young people who attempted to flee Cuba, disrupted the negotiations. In response, the EU limited its governmental visits to Cuba, reduced its participation in cultural events and invited the opposition to participate in receptions for the national festivals of its member states. continue reading

In 2008, while the majority of the 75 prisoners remained in jail, and the effects of the crisis were exacerbated by the destruction caused by hurricanes Gustav and Ike, the government decided to restart relations with the EU, which had been disrupted since 2003.

The chancellor, Felipe Pérez Roque, declared that the government of Cuba would make “clear gestures of recognition” of European policies if the EU did not vote in favor of the resolution on Cuba by the UN Human Rights Commission and added that by doing so “Cuba would sign the International Covenant on Economic, Social and Cultural Rights on the following day.” In other words, the signing of the covenant would not be predicated on a desire to improve the human rights situation in Cuba. Rather, it was political blackmail, which explains why the signature was never ratified. In the meantime, the chancellors of the EU countries revoked the 2003 sanctions and introduced a “renewed commitment” to the Common Position.

In 2010, Cuba denied entry to the Spanish MEP Luis Yáñez, and the political prisoner Orlando Zapata Tamayo died in a hunger strike. These incidents were condemned by the European Parliament. Deteriorating relations along with internal incidents led to a pledge to free all political prisoners involved in the case of the 75 activists.

In 2014, in response to the release of the political prisoners, the EU authorized the start of negotiations to establish the Political Dialogue and Cooperation Agreement with Cuba, signed in March 2016 in the presence of the High Representative of the Union for Foreign Affairs and Security Policy Federica Mogherini, and the Cuban chancellor Bruno Rodríguez.

From that moment to the first and second EU-Cuba Joint Council (in May 2018 and September 2019, respectively), there was no progress regarding human rights.

More recently, in June 2021, Cuba’s conduct received three forceful blows that indicate a possily decisive turn:

On the 10^th of that month the European Parliament condemned the existence of political prisoners, the persecution and arbitrary detention of dissidents, and insisted that the Cuban authorities release all political prisoners and those who were arbitrarily detained for exercising the freedom of expression and assembly.

On the 20^th, in its Annual Report on Human Rights and Democracy in the World, the EU recognized that in Cuba freedom of expression, association and assembly remain subject to important restrictions, and it affirmed that the government of Cuba is not inclined to support the recommendations of the EU member states.

On the 30^th, the Lithuanian Parliament, the only country that had not ratified the Political Dialogue and Cooperation Agreement, upped the ante: It demanded “the unconditional release of political prisoners” and mentioned by name the persecutions of Tania Bruguera, Luis Manuel Otro Alcántara, Maykel Castillo, Denis Solís, Luis Robles and those held as a result of the protest on Obispo Street, among others, and thereupon declared that “it is not politically advisable to ratify the Agreement, effectively nullifying it.

These events have created an unforeseen scenario in Cuba-EU relations.

What lies behind these events was a dismantling of civil society after 1959, the suppression of the most basic civil and political rights, the elimination of private property on the means of production, and the monopoly of the party/state/government over politics, culture, education, and the media.

The current government of Cuba, essentially the same one that debuted in 1959, incurred responsibilities and interests it is prepared to defend. This explains the limited and contradictory nature of its reforms, and at the same time, it reflects its great weaknesses, disguised by impotent gestures and speeches. Within this complex scenario lies the importance of the EU as a partner toward democracy.

“The only thing that can save the Agreement is a public dialogue with civil society and the execution of the European Parliament’s resolution of last June 10th.”

One desirable and beneficial solution to achieve the agenda of the Political Dialogue and Cooperation Agreement would be to make at least five demands additional of Cuba:

Require concrete actions and not verbal agreements for help, as has occurred since the Common Position was adopted in 1996.

Freedom for all political prisoners, an end to arbitrary detentions, persecution and any other violations of rights and human dignity.

The addition of Cuba to the Covenant of Political and Civil Rights and the International Covenant on Economic, Social and Cultural Rights signed in 2008.

The coupling of Cuban law to the United Nations Charter as well as all international instruments of law.

The fomenting of spaces, mechanisms, exchanges, and cooperation with independent civil society in Cuba, establishing direct relations between associations of civil society of both parties without state control.

These minimal requirements, based on Cuba’s needs and on its relations with the EU for twenty-five years, should definitively constitute the lodestar for current and future relations for the good of Cuba, the Cuban people, and the EU.

Translated by Cristina Saavedra

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