The Cuban Revolution has always raised great passions. Millions within and outside the island are split between those who applaud and offering moving excuses, or those who clench their fists and launch incendiary accusations. But without a doubt, among the picturesque barbarities that flourish under the tropical sky there is one that is particularly atrocious: the condition of semi-slavery affecting public health professionals. To shed some light on the matter, I suggest you follow me through this attempt at a chronicle.
Imagine for a moment you decided to study medicine in Havana and graduated in 1994, during the worst economic crisis in our history. Some of your friends from high school, who take life a little more lightly, decided to raise and sell pigs, open their own businesses, or start working in tourism. Once you graduate, after six years of personal sacrifice, you naturally aspire to live honestly on your salary, but it starts at 231 Cuban pesos a month, that is you receive less than two dollars for a whole month’s work for almost two years.
From time to time you run into a friend from high school, who has bought an elegant car, as compared to your raggedy bicycle. But you want to get ahead so you devote four more years of your youth to study. After a total of ten years study (combining medical school and your specialty), you end up as a specialist in internal medicine, with which, given that specialty, your salary will be around 531 Cuban pesos a month, Meaning you will work a full month for a salary equivalent to $21 U.S. Meanwhile, a barman at a hotel earns $200 U.S., on one shift! The customs official at the airport earns $500 U.S. extorting the tourists, and this is 25 times the monthly salary of a doctor, again, on one shift!
This abysmal difference in living standards is the root of our dramas. Painfully, in Cuba, the well-being of your family doesn’t depend on your dedication to work or on your desire to excel, nor on the respect shown your profession, which also illustrates the chaos that has ruled our lives for the last 20 years. It is in this jungle where our doctors “fight,” not living in the encouraging world of International Cubavision TV, where the Revolution continues strong and victorious, with GDP growing 10% a decade, while the little guy suffers an economy in ruins, a complete divorce from reality, as if we are talking about two different countries.
Faced with such a hostile reality, our doctors have to invent miracles in their free time to feed their families, badly; make “magic” in the black market, work as a photographer, clown, carpenter, shoemaker or cosmonaut, always illegal, because up to a few months ago the Ministry of Labor prohibited, by Resolution, access to self-employment.
Suppose that you, a specialist in internal medicine, decide to go for a second specialty. After another four years of great sacrifice you graduate, for example, as a surgeon and now your monthly salary is augmented with 50 Cuban pesos (just over $2.00 U.S.), which is enough to buy four bars of soap. Thus, while a surgeon’s monthly salary is 623 Cuban pesos ($27.00 U.S.), a guard in the Specialized Protection Services, after a one month course, earns about 1,500 Cuban pesos monthly in cash, plus extra food and toiletries, while a cop on the beat receives up to 1,600 Cuban pesos, plus other benefits. For some obscure reason our government believes that doctors don’t merit such deference.
After getting over your shock, you say, “But come on man! If a salary isn’t even enough to buy toilet paper, become a barman, a customs inspector, even the security guard at the hospital will make out better!” I would respond: My friend, the leaders of my country literally turned the sacred practice of medicine into the famous tunic of Nessus — the poisoned shirt that killed Heracles; our doctors cannot work outside the Ministry of Public Health (MINSAP) because a Labor Ministry resolution categorically forbids it. No entity outside MINSAP is permitted to offer a doctor work. Can you comprehend it? But you meditate on this and your face lights up: “Emigrate! To some country that needs doctors, at least temporarily, while things improve.”
Then I ask you to make yourself comfortable and listen carefully to the good part, because here it comes…
Everything you’re read up to this point will seem like a game of little girls playing in the convent garden, compared to how you will live if you decide to travel outside Cuba as a doctor and Cuban citizen. In July 1999 the Minister of Public Health issued Resolution 54, still in force, whose details I don’t know and nor do our workers, as they are hidden from us with the zeal of a State Secret. This Resolution of Ignominy, as we call it, is the most humiliating insult inflicted upon those who embrace the medical profession in Cuba since the coming of Columbus. It states that if you want to permanently leave the country, or even do so temporarily, you must ask the Minister of Public Health for “liberation” from the sector.
That is, if the happy idea occurs to you to visit your family or friends abroad during your vacation, you must wait an obligatory five years of your life at a minimum (!!), during which you will be held against your will by the Ministry of Public Health, with no options. It doesn’t matter if you just graduated or if you’ve been working for 30 years, both have to wait five years! I know, personally, cases held for 7 years before their “liberation.” Even retired doctors and dentists are held for three years before being allowed to travel; even a nurse faces this aberration!
Let’s clarify that from the moment that you begin the paperwork to travel, you will automatically be placed on a list of the “unreliable,” and will be relieved of all your administrative posts and teaching positions, if you have any, and you will be transferred from your job to one further away and that is a demotion. As the years pass marriages break up, children are traumatized, parents die without seeing their children again.
I can’t adequately describe the human suffering that is caused by the monster to those who see their rights undermined, but none of this concerns the Union or Parliament: they can always blame the Cuban Adjustment Act for your death if instead of resigning yourself you improvise a raft and end up devoured by the sharks. As you can see, under such circumstances to speak of semi-slavery is much more than a euphemism.
*Footnote: As of two decades ago, two currencies circulate in Cuba: the Cuban peso (CUP), also called “national money” — in which workers receive their wages — and the convertible peso (CUC), also called “convertible currency” — which is used in the chain of hard-currency stores that accept only this money.
1994: 1 CUC = 1 USD = 140 CUP
Since the late 1990s to 2001: 1 CUC = 1 USD = 21 CUP
September 2001 to today: 1 CUC = 25 CUP
(To be continued …)
August 17 2011