CubaBrief: At least 13 Cuban psychiatric patients died last week at the Holguín Psychiatric Hospital. How psychiatry is weaponized in Cuba. Setting the record straight on Cuban healthcare.

Hospital Psiquiátrico Provincial de Holguín  (Fotos: ITH/Facebook)

There are reports from different health care professionals in Holguin on the cause of the deaths: two cited “bronchopneumonia and bronchial aspiration”, and another cited that they had “died from malnutrition, anemia and bronchopneumonia, and “in short, due to poor care,” said one of the doctors, who also alluded to the cold and the lack of supplies suffered by the victims.

News of this kind has previously been reported from Cuba.

Three of 26 patients who died of exposure in January 2010 in Cuba.

Images from Havana’s psychiatric hospital, known as Mazorra, that were smuggled out in January 2010, for instance, revealed that the inmates had endured terrible suffering, and were dying from exposure to the elements. Claudia Cadelo, who is currently outside of Cuba but was living there at the time, wrote in 2010 on how she felt after seeing these pictures:

When I opened the little folder called “Mazorra” a series of monstrosities hit me in the face and I couldn’t stop looking at the cruel graphic testimony. A friend who is a doctor visited and while he analyzed images I didn’t have the courage to look at, expressions like, “Holy Virgin Mary, Blessed God, What in God’s name is this?” issued from his outraged throat, mixed with obscure pathologies and the names of diseases both treatable and curable. Enormous livers, tubercular lungs, and wormy intestines are the proof, Senora Arlin, of the sacredness of life in Cuba. Meanwhile The Roundtable throws a fit because the death of Orlando Zapata Tamayo has unmasked a crumbling public health system, and they try to cover up the disgrace of seeing soldiers dragging and beating a group of women dressed in white with flowers in their hands. I ask myself, Gentlemen Journalists, when will they explain to Cubans the reasons why twenty-six mentally incapacitated people died in inhumane conditions during their confinement in Mazorra?

Thanks to the brave independent journalists who made the photographs public and the still-unknown whistleblower who revealed what had occurred, Havana was compelled to admit what had occurred.
On January 15, 2010, The New York Times reported that “26 patients at a mental hospital died during a cold snap this week, the government said Friday. A Health Ministry communiqué blamed ‘prolonged low temperatures that fell to 38 degrees.‘”

The troubles in the Cuban healthcare system are not limited to the psychiatric sector, and reflect systemic problems arising from the regime’s dictatorial nature, and subsequent lack of transparency. Katherine Hirschfeld, is a medical anthropologist who spent time in Cuba examining the healthcare system and author of the book Health, Politics, and Revolution in Cuba Since 1898 published in 2009. In 2018 Professor Hirschfeld in the journal Health Policy and Planning made the case for democratic norms generating better results in public health in “Response to ‘Cuban infant mortality and longevity: health care or repression?’” and analyzed the shortcomings found in Havana’s governing style.

”The regime governs from the top down, as a dynastic military dictatorship that does not permit anyone outside the government—no independent associations of health professionals or journalists—to objectively assess policy outcomes. The role of public media in an autocracy is instead to praise the regime and explain away its failures as the work of real or imagined political enemies. Public information about health trends is correspondingly configured to fit these predetermined narratives.”

Daniel Raisbeck and John Osterhoudt at Reason on April 18, 2022 premiered a documentary on “The Myth of Cuban Health Care” that confirms the claims made by Professor Hirschfeld. The difficulty is that the Castro regime’s propaganda networks and agents of influence continue to push the positive healthcare narrative in the media and academia, and anything that does not fit the narrative is memory holed. Therefore, it is important to share this documentary and counter the false narrative.

This poor care is not just limited to the substandard conditions and negligence, but also to Cuba’s communist government’s history of using psychiatry to torture dissidents. The Politics of Psychiatry in Revolutionary Cuba, written by Charles J. Brown and Armando M. Lago, was published in 1991 by Freedom House and Of Human Rights. It detailed the political exploitation of psychiatry in Cuba during the Castro regime.

The book is referenced by Carlos A. Aguilera in his article published in No Country Magazine on May 14, 2021 reviewing the photo exhibit “The Ten Days in Mazorra of Damaris Betancourt” [ Diez días en Mazorra (1998) ] in which she was granted access to the psychiatric facility. Her photos of the facility do not leave one with a positive impression. One year later, “Jesús Muñoz’s documentary, La revolución de Mazorra (1999); an agitprop film by the regime to show the “excellence” of its psychiatric institution, with distressing fragments of slavery and caricature, where patients receive constant orders and look like fake Stakhanovs” was premiered. Muñoz’s “documentary” fails to convince viewers with a critical eye, and especially those who have read Paul Hollander’s work.

Vladimir Bukovsky, a Soviet dissident who died unexpectedly on October 27, 2019, in England following a heart attack, wrote the preface to The Politics of Psychiatry in Revolutionary Cuba. Bukovsky had experienced the abuse of psychiatry for political reasons in the Soviet Union first hand and written about it, and was able to provide a broader context to what was happening (and still happens) in Cuba. Below is his preface.

On the Outskirts of the Empire

Vladimir Bukovsky

 After reading the documents and testimonies collected in this book, one can feel disgusted and outraged, but not surprised. We have learned long ago that Communist regimes, be they in Vietnam or Cuba, Ethiopia or China, are very much alike: just the sparks, the embers of the huge fire set in the world seventy-four years before. Actually, we would be surprised not to find familiar features in each of them because, to borrow Solzhenitsyn’s metaphor, they are like metastases of the same cancer striving to reproduce itself in every part of the globe. Cuba in this regard is unique only by the hasty pace of the disease: it covered in thirty-two years what the Soviet Union achieved in seventy-three. Within a single generation, Cuba advanced from “revolutionary justice” to “socialist legality,” from liquidation of “class enemies” to “political re-education” and psychiatric treatment of those “apathetic to socialism.”

There are, of course, some differences, too. Strictly speaking, the Cuban regime, where the supreme leader combines in himself Lenin and Stalin, Khrushchev and Breshnev, does not need to employ psychiatric repression. Invented at the time of “peaceful coexistence,” perfected in the era of détente, Soviet political psychiatry was intended as a camouflage, allowing the regime to present a more “liberal” image while continuing political repression. In the Cuban context, however, it became just another form of torture. There is no political need for sophisticated diagnostics, no sudden epidemic of “sluggish schizophrenia”[1] among dissidents, no Cuban equivalents to Dr. Lunts and Professor Morozov.[2]

Quite a few dissidents were actually diagnosed as sane, or not diagnosed at all, before being sent to the psychiatric gulag and subjected to electric shocks. I imagine even Dr. Lunts would have been outraged seeing such a barbaric application of his elaborate theories.

In short, this is not yet a political abuse of psychiatry as we know it, but rather a bad imitation of it by a not too bright apprentice. One wonders why did the Cuban comrades bother at all to borrow this latest achievement of socialism, if they are not using it properly? Could it be a result of a general Soviet pressure to “liberalize” the Cuban regime and make it more presentable? Or, was it just an instruction from Moscow, routinely dispatched to the outskirts of the empire and wrongly interpreted by a lazy official? Perhaps we will never know.

The fact remains, however, that the first steps toward the political abuse of psychiatry have been made, and further developments are quite likely. Once the political need for a more civilized image of the Cuban regime is accepted in Havana, new better dressed, and cleanly shaven leaders of the Cuban Revolution will appreciate the full potential of the Soviet invention. Then we will hear more and more stories about mental disorders afflicting Cuban society, and it will become much more difficult to cure than now.

Vladimir Bukovsky

Cambridge, England

[1] A diagnosis commonly used against Soviet dissidents in order to commit them to mental institutions. The concept of “sluggish” or “creeping” schizophrenia was developed by Professor Andre Snezhnevsky, whose diagnostic framework had a major impact on Soviet psychiatry until his death in 1987. For more on the role of diagnosis in the Cuban model, see pp. 21-22

[2] Dr. Daniil Lunts and Professor Georgy Morozov are probably the most infamous practitioners of Soviet psychiatric abuse. Lunts systematically perverted his diagnosis of human rights activists and other patients while serving at the notorious Serbsky Institute of Forensic Psychiatry in Moscow. Morozov served as the head of the Serbsky Institute.

No Country Magazine, May 14, 2021

Visual Arts

The Ten Days in Mazorra of Damaris Betancourt

By Carlos A. Aguilera


Although the use of “psychological profiling” was common practice in the European communist parties of the 20th century —including those carried out by the Stalinist Popular Socialist Party (PSP) in Cuba during the years of the Republic— as historian Julio César Aguilera recalls in a recent interview about his book El soviet caribeño. La otra historia de la revolución cubana (2018),[1] it is also true that it was not until 1959 —at least on the island— that psychiatry became a state device, a functional fold of the punitive machine.

The latter is not only supported by The Politics of Psychiatry in Revolutionary Cuba (1992),[2] the excellent study by Brown and Lago on the horror that twenty-seven political prisoners had to live through between the 1970s and 1980s at the Havana Psychiatric Hospital (popularly known as Mazorra, having been founded in 1857 on land that bore that name), but documents such as those of the National Conference of Psychiatric Institutions in 1963, where the role of the new institution and its submission to the hygienic-ideological model that Castroism was struggling to put into practice is made clear:

[…] it is necessary to work together with the comrades of the Ministry of the Interior on this aspect, in the proposed law, in the future articles on the mental hygiene thing, of how these issues should be foreseen; first foreseen, and also how they should be dealt with, how these issues should be defined, so that the Revolution has a defined criterion, not the criterion of the Ministry of Public Health or the Ministry of the Interior, but a criterion as a whole of the Revolution on these issues […]. We believe that at least it should be remarked that we are going to work together, with all the factors involved in this, in the treatment of these issues. And, furthermore, in the matter of mental hygiene, which undoubtedly mental hygiene cannot be, in a socialist country, considered apart from living conditions; that is to say, there is no mental hygiene without overcoming living conditions. So, mental hygiene is being carried out, in any case, when making the Revolution and building socialism. But even that has to be included in the Law.[3]

A model which —as is well known— not only acted against the “dark areas” of society, that is, where crime affects the majority, but against homosexuals, dissidents, “elvispreslians,” “sons of bourgeois,” people who did not want to work, “sick people,” and against all those who did not fit in the sacrificial territory, in the pure image of the pure (and revolutionary) man that was demanded.

Had not Fidel Castro made this same demand very clear in his well-known “Closing speech for the VI anniversary of the assault to the presidential palace,” delivered in March 1963, where he not only asked for more production, but also imposed a sort of horizon of offering, of guilty devotion before the Moloch-revolution?

To work with enthusiasm always, no matter the obstacles, no matter the action of the enemy, no matter the ignorant! Reason is with us, we are in the right, we have the energy, we have the initiative, we have history with us![4]

Moloch that would have among its main virtues the one of showing the way to the “people” through punishment, voluntary work, null gratification, precariousness, collective vigilance and censorship…

Through applause.

Reason that, if we look at the countless number of people escaping by sea since the seventies, plus Camarioca (1965), Mariel (1980), the Rafting Crisis (1994), or the individual and massive defections in different countries…, Cubans never fully grasped (on the contrary, all these escapes will eventually become one of the great economic and symbolic tragedies of totalitarianism), although in some areas or communities it has apparently been imposed.

One of these areas will be precisely mental health.

An area managed in Cuba from the psychopolitical sphere —to use one of the terms in vogue in Cuba in the sixties— something that, as can be inferred from the above, started much earlier, much, much, much earlier even than that National Conference of Psychiatric Institutions organized by the Ministry of Health, inaugurated only two years earlier, the medical services of the MININT and the —already by then— very well structured Cuban State Security, built from the old Stalinist center of the PSP and the Military Intelligence Service (MIS) created by Raul Castro on the Sierra Maestra; it began —it could be said— with that feature in Bohemia in 1959, “El hospital de dementes de Mazorra: una vergüenza nacional,”[5] and its narrowing of the whole past (the whole republic) to a locus occupied by evil, a compromise of “incapacitated men without conscience.”

Story that, as Pedro Marqués de Armas rightly qualifies in Ciencia y poder en Cuba (2014), was nothing more than the “old discourse of the Cuban frustration, now with particular emphasis on the opposition shamelessness/cleaning up, a duet that had been gaining strength since the 1940s”.[6]

(By the way, in the editorial of that same issue of Bohemia magazine, Batista’s “totalitarian regime” is compared to the concentration camps of Dachau and Lidice).

Is it not precisely this blank slate, this ideological-mental hyperbole that Castro’s terror takes advantage of to impose its vision, its identity vampirization?

This is what can undoubtedly be seen in two very different pieces that happen to have been created around the same years:

—Jesús Muñoz’s documentary, La revolución de Mazorra (1999); an agitprop film by the regime to show the “excellence” of its psychiatric institution, with distressing fragments of slavery and caricature, where patients receive constant orders and look like fake Stakhanovs.

—And Damaris Betancourt’s photographic series, Diez días en Mazorra (1998); a project of about one hundred images that with almost the same people and under very similar conditions achieves a very different punctum to Muñoz’s La revolución

[ Full article here ]