14ymedio, Marcelo Hernandez, Havana, 5 January 2017 — The line in front of the Customs counter extends several yards. It is hot and flies land on the passengers who have just arrived at the airport in Havana. Among their luggage are air conditioners, huge bags and some boxes labeled “medicines” that, in all likelihood, include bottles of multivitamins and food supplements, products whose demand has grown in recent years.
The supplements — initially introduced on the Island as a support for the feeding of children, the elderly or convalescent people — are now widely consumed by young adults, people who practice sports frequently or those who want to avoid illness.
“It is a consumption that is outside of medical control and that people continue for long periods of time without really needing it,” says Caridad Herrera, who for more than two decades worked in the specialty of comprehensive general medicine in a Havana polyclinic.
“I have had patients who use and abuse these pills as if they were eating candy, just because they think they need more vitamins or because one of their children sent them some ‘nice’ pills from over there,” the doctor complains. “People think they can get healthy just by taking this every day, but it’s the lifestyle that they maintain that really influences their health.”
The World Health Organization (WHO) recommends strict limits on the consumption of nutritional supplements and vitamins. It also warns that raising the doses can cause serious problems, including birth defects and increased mortality among adults.
However, most Cubans on the island seem to be unaware of these warnings and the consumption of vitamins is increasing, according to several specialists consulted by this newspaper. The intake of these supplements has become one of today’s visible status symbols in Cuban society.
“You will feel like new, happier and more vigorous,” reads a classified ad in one of the numerous digital pages where thousands of Cubans go to buy both aspirin and cars. “If you want to be more active every day and full of life call me,” invites the text in an ad that offers everything from “vitamin C gummies for children” to “flavored tablets for adults,” all “very colorful and high quality.”
The informal market has an extensive variety of vitamins and nutritional complexes that contrast with the empty shelves of state pharmacies to which many continue to go in search of the old and tired standby Polivit, which has been taken to alleviate the population’s malnutrition for almost 25 years.
Several medical studies undertaken starting in the great recession — the so-called Special period — that was set off with the fall of the Soviet bloc revealed that Cubans suffered serious deficiencies of vitamin A, thiamine and niacin, in addition to the entire group of B vitamins. Those deficiencies were announced through the independent and foreign press, despite the Government’s attempts to silence the problem.
The Ministry of Public Health began distributing multivitamin tablets, which during the first year were delivered free of charge through family doctor’s offices but later became a part of the regular inventory of pharmacies at subsidized prices. The supplements leant their names — Polivit or Multivit — as a symbol of the scarcity of those hard years.
The nutritional complex includes folic acid, in addition to vitamins A and B, and has an intense yellow color, to the point that some used it to dye rice at the time when food dyes disappeared from store shelves. There were also jokes about the Polivit and even the suspicion of some who renamed the pills as “soul stealers,” in the midst of social paranoia due to excessive government controls.
In 2003, a study by the Institute of Nutrition and Food Hygiene (INHA) revealed that 26.4% of the population consumed vitamin supplements. From a sample of almost 50,000 people interviewed, almost three-quarters of those who reported that they did not take these nutrients, said it was because of “lack of the habit” or because they felt they the supplements made them more hungry.
In the families that did consume vitamins, the INHA found that children and the elderly were almost always prioritized. The study also reported the dissatisfaction of Polivit consumers due to the variations in the supply that prevented many of them from taking them regularly.
“I have been taking it for almost 20 years because I have had many health problems and I need to strengthen my diet, which is not very varied either,” says Azucena, 68, who sat outside the Carlos III Street pharmacy this Saturday, asking if Polivit had arrived.
Last December, the Ministry of Public Health and the state-owned Biotechnology and Pharmaceutical Industries Group (BioCubaFarma) admitted the “instability” in the supply of medicines and supplements. Delivery failures from raw material suppliers affected production, as more than 85% of the compounds must be imported.
Azucena also regrets that the Polivit has “an unattractive presentation” and hard tablets. “To convince a child to take it, a little grace is needed.”
To alleviate the shortage and the “grayness” of Polivit, many families turn to their relatives abroad or buy supplements in the informal market.
Customs allows the importation of up to 10 kilos of medicines, which “are exempt from paying customs duties, provided that they come in their original containers and are separated from the rest of the articles,” so that a good part of the “business of vitality” is nourished by travelers’ personal imports.
“Every time I come, I bring my 10 kilograms of medicines and most of them are vitamins for my family,” says Rebeca Orizondo, a Cuban woman who has lived in Miami since she left the island during the Rafter Crisis in 1994. “My mother, who is already very old, can’t miss taking Omega 3 and calcium, so I keep her supplied.”
These small pills also are an expression of the growing social differences across the country and their use is often linked to access to convertible currency or simply contacts with people living abroad.
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