Category: Translator: GH

In 2003, according to the poster, Cuba’s public health institutions had 286 hospitals, of which 83 were general, 34 clinical-surgical, 26 paediatric, 18 gynaecobstetric, 18 maternal and child, 64 rural and 43 specialised. In addition, there were six cardiocentres, 289 maternity homes and 1,961 well-stocked pharmacies. The infant mortality rate was 4.8 per 1,000 live births and life expectancy for both genders was 77.79 years, while for women alone the number exceeded 80 years of age. Some 99.1 per cent of the population was served by the family doctor’s offices, which were part of the primary health care structure.

A lot of water has flowed under the bridge since then, says a MINSAP (Ministry of Health) official, “infant mortality is over nine per thousand live births and in many provinces it rises as high as twelve or thirteen percent. More than a third of the hospitals have been closed or do not provide the services for which they were designed. Sixty percent of the family doctor’s offices are no longer functioning. The number of doctors, nurses and health technicians has fallen by more than 75,000 compared to 2003.”

As an example, “Between 2022 and 2023 alone there are 46,000 fewer health workers. Out of that number, 12,000 are doctors. Fifteen years ago, community polyclinics had weekly consultations with medical specialists. Today, patients have to travel, even from one province to another, to be seen, and consultations are usually every two months. Stomatology clinics are either closed or run informally as private entities. Life expectancy has fallen to 73 years for men and 76 for women. Food and medicine shortages contribute to this decline. Only emergency surgery is being performed. Hospitals are short of everything from disposable needles to adhesive tape. It’s an absolute disaster,” he says.

Dr. Geiser tries to do her job with hardly any medical supplies. “We can carry out some treatments thanks to the help of neighbors who have donated a little cotton and gauze. When people come for injections, they bring their own disposable needles. Most of the treatments I prescribe are based on green medicine. It’s very painful to treat the child of a low-income family or an old person who gets a pension of 1,500 pesos and who can’t buy the antibiotics for treatment in private businesses because they don’t have the money.

On a piece of paper from a school notebook, Dr. Geiser writes down the medicines to be taken and the treatment to be given. The pens are given to her by her patients. “We keep things going thru sheer willpower. My salary of 6,000 pesos is equivalent to 20 dollars. The nurse’s salary is 4,000 pesos. We open the clinic two or three times a week. The rest of the days we have to go out on the streets, to get food for our homes. Although it’s wrong, most doctors and health workers earn extra money by treating patients on the side. It’s the only way to avoid starving. The other way is to find work abroad.”

“Although the government keeps 80 percent of the salary in foreign currency that they pay you, you can at least get between 7,000 and 10,000 dollars, depending on the length of your stay and the country you go to. The best destinations are Italy, South Africa, Qatar, Mexico. The worst are Haiti and Venezuela. If you want to get a good posting, you have to pay two or three thousand dollars under the table”, explains the doctor.

Although medical service exports managed by the government bring in billions of dollars annually, most of the hospitals serving the population in Cuba are in fair or poor condition. Hygiene leaves much to be desired, as does medical care. Patients admitted to medical facilities must bring sheets, towels, a fan, drinking water and a bucket for washing, among other things.

According to the MINSAP official, “between 2008 and 2015, between 7 and 11 billion dollars were earned every year from export of medical services. Enough money to maintain the quality of the health system on the island. But GAESA (a military-run conglomerate) uses that money to build hotels and other businesses.”

According to figures for the first six months of 2024 published by the state-run National Statistics and Information Office (ONEI), the leisure and tourism sector received a budget fifteen times higher than agriculture, livestock and forestry. And 17 times more money than Public Health and Social Assistance, which received 769 million pesos. Although there were 46,000 fewer health workers in 2023 than in 2022, the regime has more than 22,400 Cuban health workers in 59 countries. And it is negotiating new contracts with other countries.

The shortage of medicines, poor diet, and the ageing population, with nearly 25 percent of the population is over 60 years of age, all contribute to the progressive deterioration of the health of the population. For over ten years, more people have been dying in Cuba than being born.

Dania, a psychologist with two decades of professional experience, says that “suicides and suicidal behaviour have increased by 23% in the last four years in the Diez de Octubre municipality, the most populated in Havana and the third most populated in the country after the municipalities of Santiago de Cuba and Holguín. A worrying fact: if a decade ago most of those who took their own lives, or attempted to do so, were elderly people, mainly men who lived alone, in recent years the suicide rate among young people and adolescents between the ages of 12 and 35 has skyrocketed.”

“Historically, suicide in Cuba is among the first ten causes of death. The rate per hundred thousand inhabitants has remained above 12 and 15 percent. But since 1972, the level has grown to be among the highest in the world and the fourth highest in Latin America. In 1982, a grim record was reached when suicides increased to 23.2 percent. We do not have updated figures now. But I see many cases of patients who have made an attempt on their lives due to frustration and lack of future”, the psychologist points out.

For the Castro regime it is more important to build hotels than to buy medicines.

 Translated by GH

“Every two days I have to carry dozens of buckets of water from a turbine two kilometres away to the third floor of the building where we live. Several neighbours go in a cart and make two or three trips. A miserable life. In their free time, the men pass the time with cockfighting or a group of friends drinking a couple of bottles of rum and relieving their frustrations. In these villages there is no future. The younger people go off to the city or they emigrate. We are left, the oldest assholes, who never try to do anything to change our destiny.”

His flat is in urgent need of a lick of paint. There are dark patches on some parts of the ceiling due to damp caused by leaks from broken pipes. The termites have shattered the Miami-style windows. The most valuable object is an old Haier refrigerator, that the dictator Fidel Castro bought for a knock-down price in China when he implemented the so-called ’energy revolution’ in 2006, which was supposed to save the country’s electricity. Eighteen years later, the fridge is hardly working. The gaskets of the equipment have come loose and Luciano’s solution was to screw a crude metal clip on the door that allows the fridge to be opened and shut.

The furniture in the flat is ancient. The television set, with a 21-inch screen, has cathode ray tubes. In the kitchen hang two slotted spoons, two cast-iron pans, and a rice cooker that has lost its enamel. The three beds in the two rooms need to be replaced, as do the mattresses. “When the old woman urinates, as we don’t have disposable pads, we have to carry the mattress up to the roof of the building to dry it out in the sun. And when the water crisis hits, we relieve ourselves in nylon bags, which we then dump in the fields.

Luciano believes that in 2014 they were still eating well, by Cuban nutritional standards. “We had bread with tortillas and coffee with milk for breakfast and what was left over from dinner for lunch. We ate pork frequently, fish, chicken and sometimes beef, which I bought under the counter and a pound cost 25 or 30 pesos. Nowadays, a pound of beef is not less than 1,200 pesos. We couldn’t go to a hotel in Varadero, but we had breakfast, lunch and dinner seven days a week. Now we can only eat once a day.

According to a study carried out last July by the Cuban Observatory for Human Rights, extreme poverty on the island is close to 90 percent of the population. According to surveys by the Food Monitor Program, Cuban families currently spend almost all of their income on food, whether they have a low or a good income, whether they receive dollars or not. Nutrient deficits, lack of food hygiene, and the stress associated with food insecurity are “is having adverse consequences for the health of Cubans,” the organisation says.

Likewise, the “phenomenon of hidden hunger”, used by the FAO to describe prolonged undernourishment, is “very common in Cuban society”, which consumes more carbohydrates and sugars while going without fresh fruit and vegetables, as well as meat and dairy products, which has led to high rates of diabetes, high blood pressure and gastritis, among other ailments, said Food Monitor.

But it is not only food that is missing in Cuba. Basic services such as electricity, liquefied gas and public transport hardly work. Blackouts outside Havana often last eight to ten hours a day, or more. The shortage of medicines is more than 65 percent. Rubbish piles up for days in the streets, especially in the capital, which is dirtier and more abandoned than cities in other provinces. Due to breaks in the aqueduct, 50 per cent of the drinking water that is distributed does not reach homes or is lost through leaks. Hospitals are a mess. Patients must bring disposable syringes and cotton wool, among other supplies. And if you want good care, you need to give money or gifts to the doctors and nurses.

“The water supply cycles in the neighbourhoods of Holguín exceed 55 days,” says Yoss from Holguín. From Santiago de Cuba, Rudy says that in several areas of that city they have been without drinking water for more than 60 days. “The houses are full of containers. Those who have dollars build huge cisterns. For lack of water, despite the tremendous heat, there are people who bathe every two days. It’s as if they were in a war.

Many Cubans see no way out of the country’s structural crisis. For Luciano, from Pinar del Río, there are three options: “Emigrate, continue to put up with it or take to the streets to protest. Either we put on our trousers, like the Venezuelans, or this government starves us to death”.

Translated by GH

“I have collected money for the bolita (illegal lottery) and sold beer and bread and steak. Like many Cubans, I have done everything, trying to live as well as possible. When in 1993 they authorised self-employment, I had some money saved up thanks to those little tricks. There is a myth that most of the businesses that emerged in the country were opened with dollars sent by family members living in the United States. In some cases this was true, in others it was not. Many ’bisnes’ in the depths of rural Cuba have been financed with money earned from the sale of food, clothes or construction materials on the black market.

According to Yoel, “these attacks on MSMEs and the self-employed were to be expected. You would have to be very naïve to believe that a government that is anti-capitalist is going to let private businesses prosper. They allow them because the system has broken down. Private business is an umbrella under which these scoundrels protect themselves. They accept us, but with the boot on our backs, a lot of regulations, very high taxes, an army of inspectors who inspect you and when they feel like it, they put you in jail”.

“Opening a business allows you to earn money and live without the crumbs from the state. Most of us are double bookkeepers and under-declare when paying taxes. It’s a war. They screw you with decrees, threats and lies. And we pretend to comply, but then we do whatever we want. When they order businesses to stop, people know what to do. Either they get out of Cuba or they continue to do the same thing informally. Since the emergence of self-employment in 1993, everything has been a government bluff. The private sector is designed for survival, not to make lots of money. These openings serve as international propaganda to sell themselves as reformers.

“We are labelled as entrepreneurs out there. But almost none of us have studied business administration or marketing techniques. In my case, I was a go-getter who worked my way up to owning several businesses. If I see that things are getting hot, I will know that it is time to get on the plane. But behind me, other ’entrepreneurs’ will emerge. Until the system, which is incapable of generating wealth, changes, that will be the the way it goes,” says Yoel.

The owner of two small stores in the old part of Havana, a guy who knows his way around the sewers of the corrupt local bureaucracy, thinks that “it is likely that the government will try to clamp down on MSMEs. This campaign is aimed primarily at autonomous private businesses, which compete against MSMEs run by front men for high-ranking government officials or retired military officers. The reason is simple: they are more efficient and have developed a network of suppliers that works.

“The state, used to receiving dollars from exports, tourism, sales in foreign currency shops and the banking system, thought that we would not be a problem, not least because we could not access foreign currency. But we have been creative. The sales cycles are faster. We have accounts in foreign banks. And to replenish our supplies, we buy dollars on the street at the informal market price. The state-owned companies can’t compete with us even on a tilted playing field” says the entrepreneur.

Dunia, a hairdresser, agrees that “the new regulations are a declaration of war on the private sector. Some will leave the country or shut up shop. Others will start working under the counter. Every Cuban knows that to live in any comfort we have to fend for ourselves. The state can’t even guarantee the seven pounds of rice it provides through the ration card. The government should concern itself with dealing with poverty, not fighting the people who create wealth.

An official of the ONAT, the institution that governs private labour, revealed to Diario Las Américas that the regime’s intention “in addition to more rigorous supervision of the non-state sector, is to recover the two billion that the banking system has stopped receiving. From now on, priority will be given to the opening of state-owned MSMEs. (Micro, Small, and Medium-sized Enterprises). Especially in the commerce sector and in companies that are at a standstill or generate losses for the state. There is the intention that political and mass organisations, such as CDR (Committees for the Defense of the Revolution) and FMC (Federation of Cuban Women), can open MIPYMES that allow them to finance themselves with small shops in the neighbourhood, as well as private stores, where they can sell food and confectionery at lower prices.

Gustavo, an economist, considers that “these new measures show that the government is living in a surreal world. This interference in private property, the idea that MSMEs should be chained to bankrupt state-owned companies and the earmarking of a voluntary reserve to finance vulnerable sectors is a crazy project. And it will fail. No entrepreneur is going to allow the authorities to use his or her capital to finance Cuba’s failed economic model. For entrepreneurs to use the inefficient national banking system for their purchases abroad is nonsense. For the state to implement MSMEs is absurd. It doesn’t exist anywhere in the world.

The government is well aware of this. Its strategy is to supplant autonomous MSMEs with entities under the control of relatives and government officials. It was already happening. Now the mask has definitely come off.

Translated by GH

A pre-university teacher explains what the ‘cultural decolonisation and history learning’ programme is all about. “We were given a seminar as part of the course. The authorities consider that there is a regression in the teaching of history to children and young people. They claim that the use of social media, watching US serials and films, promotes a ‘hegemonic cultural discourse that distorts revolutionary values’. Imagine standing up in a classroom and talking such nonsense that nobody believes, when most students have plans or dreams of emigrating. They don’t see that it’s ridiculous.”

A primary school teacher comments that the education directors in his municipality, “proposed to us that among the activities to encourage love for the revolution and its leaders, we should organise visits to the local museum and the Fidel Castro Centre, which is located in Vedado. These people live in Narnia. They don’t know that the municipal museum has been closed for two years. And how am I going to get dozens of children to Vedado with no transport in the capital? Unless the Ministry of Education provides buses to take us there and back. These are things they say to make themselves look good to the government, but they know that they can’t be done in current conditions in the country.”

An education official notes that “the official version of the new school year is totally out of touch with reality. In the municipality where I work, only ten percent of the schools have been repaired. Almost all of them have closed toilets, almost none of them have water, and a large part of the school furniture is in a bad state. A very serious problem is the lack of teachers. According to the Ministry of Education, there is a shortage of 24,000 teachers on the island. It is probably many more than that. Half of the teachers do not have teaching qualifications. Some are professionals who are hired to teach at the primary, secondary and pre-university levels.”

“Others are ‘instant teachers,’ as they are called, because they are pulled out of their training in the second or third year of their degree. There are cases of teachers who finish a class shift in one school and have to walk a kilometre to another school to teach because there is no teacher for a certain subject. Due to the shortage, recruitment rules have been relaxed. I have had to rehire people who for various reasons have been expelled from education. In addition to this disaster, school supplies are not complete. We have not received the new books. They say they will arrive before the end of the year. They said the same thing last year and they never arrived,” says the official.

When you talk to relatives of pupils at all levels of education, the list of complaints is long. Reinier, the father of two primary school children, says that this year, his children are due a new uniform, “but they haven’t arrived at the shop. I have had to spend 5,000 pesos on four shirts and 10,000 pesos on four pairs of trousers, 15,000 pesos in total. And my salary as an accountant in a company is 6,400,000 pesos. Thanks to my brother who lives in Miami I was able to buy the uniforms. He also sent me tennis shoes, backpacks and school supplies. I can’t complain.”

But many parents in Cuba do not have relatives abroad. This is the case with Sonia, who admits to being extremely stressed. “My daughter is a pre-university student, I have no relatives in the US and I had to scrape together the money to buy her a mobile phone, a bag and a decent pair of trainers, because the boys made fun of her shoes in school and she had a complex. Not to mention that I have to give her money to buy something to eat when she gets out of school. And I have to pay 200 or 300 pesos for a tutor, because some teachers aren’t very good. Then the school has the nerve to ask parents for ‘help’, whether it’s detergent to clean the classrooms or let’s raise money and buy a fan so the kids don’t get so hot.”

But the issue that parents are most unhappy about is the regime’s intention to have students work for a fortnight in agriculture or fixing tiles and monuments. Diario Las Américas asked eleven families if they would allow their children to do it. All eleven answered No.

“It’s no longer enough for them to indoctrinate in schools, talking about Fidel and telling their version of history. Now they want to go back to the fateful schools in the countryside, where children were separated from their parents, working for free in agricultural work. That era is over. Times have changed,” said Maritza, a housewife and mother of two secondary school students.

In Cuba, education is supposed to be free. Luisa, grandmother of a grandson in fifth grade, thinks it’s quite expensive. “What with buying two uniforms, a pair of tennis shoes, a backpack, a lunch box, pencils, notebooks and pens, I’ve already spent 250 dollars. In a country where there is nothing, students want to go to school in Adidas or Nike tennis shoes. The schools look like catwalks. Luckily my daughter, my grandson’s mother, sends me dollars from the US for these expenses and to prepare good snacks for him.”

A pesar de tener un nivel de vida un poco mejor, Luisa reconoce que es muy deprimente la vida actual de los cubanos. “En los barrios apenas ves muchachos jugando en las calles. Y han aumentado los niños, como mi nieto, que sus madres han emigrado y son cuidados por sus abuelos». Dentro de un tiempo, los progenitores sacarán del país a sus hijos. Y en Cuba solo quedarán los más viejos.

 Despite having a slightly better standard of living, Luisa acknowledges that life in Cuba today is very depressing. “In the neighbourhoods, you hardly see any children playing in the streets. And there are more children, like my grandson, whose mothers have emigrated and who are cared for by their grandparents. In time, parents will take their children out of the country. And only the old people will remain in Cuba.

Translated by GH