Fernando Damaso, 22 October 2019 — By the end of Cuba’s colonial period, the country was suffering from a high mortality rate. Malaria, smallpox, childhood tetanus, typhoid, yellow fever and other diseases were decimating the population.
An interventionist government in the United States first assigned General Brooke, then General Wood, the task of quickly improving the country’s sanitary conditions and its overall state of health.
To this end it created the Department of Health, the precursor of the government agency established later under the same name. It was given broad responsibilities and, with the participation of prominent Cuban and American doctors, gradually managed to rid the country of endemic diseases, whose frequent outbreaks were a serious problem.
The process continued during the Republican era, with major sanitation projects and the organization of an efficient health care system made up of medical offices, relief homes and hospitals, augmented by private medical practices, located in the island’s main cities and towns. In cooperation with the Pan American Health Fund, task forces were set up to provide vector control and prevent epidemics.
Work brigades cleaned out streams, ditches, lagoons, wastelands and sewers. Residents were enlisted to sanitize their own homes. Insecticides such as the well-known DDT and the Yokel-brand mosquito repellant coils were also used along with anti-mosquito screens on doors and windows, and mosquito netting on beds.
Dengue fever was unknown in Cuba until it appeared in 1978 as a result of widespread, unsanitary conditions in urban areas and misguided eradication efforts by work brigades at the time. Once it became an epidemic, authorities were forced to train new teams and equip them with fumigation equipment purchased from Japan and brought in on aircraft owned by the Cuban national airline.
Officials made direct purchases of Malathion, considered the most effective insecticide at the time. They circumvented the U.S. embargo by enlisting Colombian drug runners, operating between Caribbean countries and the United States, to deliver it on their trips home.
Cash payments were made once personnel from the Ministry of Public Health (MINSAP) confirmed the quality of the product. The drug runners were resupplied with fuel to complete their journeys back to their countries of origin and, when necessary, were provided with lodgings and a place to rest in a marina.
Daily press reports described how Cuba was being sprayed with massive amounts of smoke. Even eggshells were being crushed because it was feared they could become breeding grounds for the dreaded aedes aegypti, the mosquito whose bites transmit the disease.
Fumigations took place around the clock, first with Malathion, then later with smoke from burning petrol. Hoping to contribute to the effort, Soviet military units stationed in Cuba provided authorities with equipment that produced clouds of smoke, which proved to be effective.
There was even an “invading caravan” which began in the west of the country and moved east along the Central Highway, fumigating cities and towns along the way. Epidemiologists leading the effort, however, doubted its effectiveness, suggesting its impact was more psychological than practical.
Then one fine day, sometime after the latest death, the epidemic was officially declared over. Among a few intimates a MINSAP official confided, “Rest assured that, as of today, no one else will die from dengue fever. If there is a subsequent death, it will be attributed to another illness.” In spite of all the measures taken, the epidemic took more than a hundred lives.
Nevertheless, dengue returns every summer. This has been going on for decades. It has unquestionably become endemic. And given the unremittingly poor state of environmental hygiene, it seems the illness is winning its war with MINSAP.
See also: In-depth reporting on Dengue Fever