“Cuba today is indeed a country of sick citizens who do not know exactly what they are suffering from. All they know is that they are being infected by “the virus” – a sinister ghost that has drifted across the entire island, wiping out its inhabitants. First come the high fevers, then red spots develop, or else peeling skin. Vomiting, diarrhea and headaches are inevitable. The hands and knees swell. Victims can barely stand on their feet, and there are those who have not walked again even after the worst is over. A limp indicates a virus survivor.”
The disease is in fact a combination of several mosquito-borne viruses, a model of “combined arboviruses” that includes dengue, Oropouche and chikungunya, as well as other respiratory viruses such as H1N influenza, respiratory syncytial virus, and Covid-19. According to figures published by the Ministry of Public Health, 5,717 new cases of chikungunya were reported in the last week, bringing the number of patients suffering from it to 38,938. As for dengue, the ministry said the disease remains active in the country’s 14 provinces and 113 municipalities.
An alarming 33 deaths were reported at the beginning of the week which the government was forced to recognize, including 21 minors – the demographic most affected by these arboviruses along with the elderly. “There are many one-month-old children who have died, and also those between two and four years of age, as well as other young people, because the vomiting and diarrhea dehydrates them and they arrive at the hospital already in a state of collapse,” a worker at the Institute of Hematology and Immunology of El Vedado told El PAÍS on condition of anonymity.
Pre-Castro Cuba’s healthcare system was superior to what came after 1959
Carlos J. Finlay, pioneering Cuban doctor
Carlos Juan Finlay (1833-1915), a Cuban epidemiologist, discovered that yellow fever was transmitted from infected to healthy humans by a mosquito vector. Dr. Finlay identified that the carrier of yellow fever was the mosquito Culex fasciatus, today known as Aedes aegypti. Finlay’s career began under the Spanish colony and continued into the early years of the Cuban Republic. Dr. Finlay was nominated for the Nobel Prize in Medicine seven times ( in 1905, 1906, 1907, 1912, 1913, 1914, and 1915). .
However, he was not the only great Cuban doctor to become internationally renowned.
Dr. Agustin Walfredo Castellanos
Dr. Castellanos described “the first practical method of angiocardiography, with which he studied several congenital malformations of the heart. Also, he designed the first automatic angiocardiographic injection device. He also pioneered the method of retrograde injection of contrast material into the aorta which was mainly used to diagnose patent ductus arteriosus.”
Angiocardiography, according to Merriam Webster is “the radiographic visualization of the heart and its blood vessels after injection of a radiopaque substance.
Dr. Castellanos and his colleagues published the first important paper on the clinical applications of intravenous angiocardiography in the Archivos de la Sociedad de Estudios Clinicos in 1937. Cuban medicine prior to 1959 was not just groundbreaking in basic research, but also in public health.
Cuban doctors in the 1930s provided the breakthrough that made above images possible.
Dr. Arístides Agramonte y Simoni
Dr. Joaquín Albarrán
America Arias Maternity Hospital Building (Havana, Cuba 1930s)
Professor James W. McGuire and Laura B. Frankel in their paper published in the Latin American Research Review, “Mortality Decline in Cuba, 1900-1959: Patterns, Comparisons, and Causes” found that “Cuba’s progress relative to other Latin American countries at reducing infant mortality was even greater from 1900 to 1960 than from 1960 to 1995. During the earlier period, Cuba led all Latin American countries for which data are available at raising life expectancy and reducing infant mortality. From 1960 to 1995, by contrast, it came in fourth and fifth respectively.”
Rodolfo J. Stusser, M.D. in his November 2013 paper, “Cuba’s Long Tradition of Health Care Policies: Implications for Cuba and Other Nations,” documented that “in 1958 Cuba had 6,000 physicians, 3,624 pharmacists, 2,260 pharmacies, about 500 laboratories, and 60 drug manufacturers, handling 40,000 different products for 6 million inhabitants.”
Post-1959 Cuba: Faked statistics, not reporting epidemics until unable to cover it up, and jailing whistleblowers
Numbers don’t lie, although the Castro regime likes to disappear and misrepresent them. Cuba has a communist dictatorship, with a regime that is not transparent and has a history of not reporting or under reporting disease outbreaks.
Downplaying and covering up Covid-19 deaths in 2020 – 2022
Our World In Data is a project of the Global Change Data Lab, whose “mission is to publish the ‘research and data to make progress against the world’s largest problems.’” They published an interactive map from The Economist, current through Jul 26, 2022 titled “Estimated cumulative excess deaths per 100,000 people during COVID.” There is a screen grab above, but when you go to the website and hover over a country the data is provided, and you can see the numbers for yourself.
This blog over the course of 2021 repeatedly highlighted questionable practices by Havana and called them out. CFC’s executive director had a letter to the editor published in The Washington Post on April 5, 2021 countering news coverage that repeated claims made by Havana with the fact that the Cuban government had repeatedly covered up or downplayed past epidemics, and was doing it again.
Havana tried to position itself, once again, as a “safe” destination for international tourists in the time of COVID-19. Thousands of tourists were left in the lurch last year in Cuba, and the conditions maybe recreated with another round of misleading propaganda in 2021.
Left out of The Economist report is the damning evidence that Cuban government officials decided early on that they wanted to be “be the first country in the world to vaccinate their whole population with their own vaccines,” and were willing to let Cubans die while they developed their domestic vaccines instead of importing them, including from their allies Russia and China in order to advance their “healthcare superpower” narrative.
In the article below The Economist repeats the same tropes about Cuban healthcare, but the COVID data leads them to conclude that Cuba’s healthcare system “is in tatters” and that “It is possible that officials under reported the deaths, too.”
Yet, The Economist in the same article claims that from 2000 through 2020 Cuba outspent other countries in healthcare. Where do they get the data to make such a claim: the Cuban government. No independent verification. In 2007 Rich Lowry reviewed the Michael Moore propaganda film Sicko in The Salt Lake Tribune and presents a description of the Cuban healthcare system in 2007 that is much the same to the one being criticized in 2022 by The Economist.
Whereas, Latin American countries engaged in campaigns to vaccinate their respective populations using vaccines that were peer reviewed by scientific journals demonstrating their effectiveness, and others from Russia and China that were less vetted, Havana waited to develop its “own vaccines” and did not begin the wide scale vaccination of the Cuban population, but was engaged in its propaganda offensive. in April of 2021.
Propaganda offensive: Vaccine Tourism – Beach, Mojitos, Caribbean and Vaccines.
Americas Society (AS) / Council of the Americas (COA) on March 29, 2021 reported on major developments in Latin America on vaccine roll outs as countries in the region strive to reach herd immunity. Below is a list of total doses administered per 100 people in Latin America, and Chile is leading with 50.38/100, the Dominican Republic is in sixth place with 7.37/100, followed by Costa Rica with 6.83/ 100. Cuba is not on the list, but in dead last was Venezuela with 0.04/100.
Over 60,000 Cubans died of COVID-19, not the 8,529 official figure given by the dictatorship, based on official statistics.
Tîcö Äwö Ôrümîlä, buried grandmother in a mass grave in the Juan González cemetery in Santiago, Cuba. (Facebook)
Official channels reported “8,529 deaths due to Covid-19 between 2020 and July 2022 in Cuba. The falsification of the reality on the island was exposed after the first reports of the Statistical Yearbook, were released containing figures from between January and December 2021, reported José Luis Reyes in Diario de Cuba.
“In the section of the document dedicated to Population, drafted by the State Office of Statistics and Information [ Oficina Nacional de Estadísticas e Información] (ONEI), it is striking that in the previous year 167,645 deaths were recorded, while the total population fell by 68,380. Although the decrease in the number of inhabitants has been steady since 2015, mainly attributed to the low birth rate, the downward curve in 2021 was about 7% per 1,000 people. In numbers, this means that while the country closed out 2020 with 11,181,595 people, at the end of 2021 there were 11,113,215.”
Based on the average number of annual deaths prior to COVID-19 hovering on average at 106,813 deaths with maximum variation above of 106,941 in 2017 places the increase of Cubans who died due to a health emergency such as COVID-19 at 60,704 (and this is a conservative estimate). Regime downplayed the impact of this plague on Cubans by over a factor of seven.
Downplaying a Zika outbreak in 2016
New Scientist on January 8, 2019 reported on a 2016-2017 Zika outbreak in Cuba which went unreported or under reported.
“Cuba’s first case of Zika occurred in March 2016. A PAHO report says the country stopped providing updates on Zika in January 2017. In press reports in May 2017, Cuba said that nearly 1900 infections had been detected up to that point. But Nathan Grubaugh at the Yale School of Public Health and his colleagues estimate that the total cases in 2017 alone would have been more than double that at 5700. “Our results therefore suggest that the 2017 Zika outbreak in Cuba was similar in size to the known 2016 outbreaks in countries with similar population sizes,” the authors write.”
Professor Duane Gubler of the Duke-NUS Medical School in Singapore, “says Cuba has a history of not reporting epidemics until they become obvious,” reported New Scientist on January 8, 2019. Professor Gubler is an internationally recognized expert on Dengue fever, and the founding Director of the Program in Emerging Infectious Diseases which is affiliated with the Duke University-Graduate Medical School in Singapore. Dr. Gubler also served as a consultant/advisor on numerous World Health Organization committees.
In 1997 he pointed out the shortcomings of Havana’s Dengue response: “The problem with the Cuban program,” said Gubler, “and those that rely on a paramilitary-type of organizational structure is they have no sustainability. Once support and funds dry up, the program falls apart and the disease will come back with a vengeance,” said the professor in the July 8, 1997 issue of Science. Consider what happens to doctors and journalists in Cuba who speak up in the midst of an outbreak, and do not tow the official line.
Downplaying a cholera outbreak in 2012
Calixto Martinez: Jailed for reporting on Cholera outbreak.
News of a cholera outbreak in Manzanillo, in the east of the island, broke in El Nuevo Herald on June 29, 2012 thanks to the reporting of independent journalists in the island. The state controlled media did not confirm the outbreak until days later on July 3, 2012. The BBC reported on July 7, 2012 that a patient had been diagnosed with cholera in Havana. The Cuban government stated that it had it under control and on August 28, 2012 claiming the outbreak was over. Independent Cuban journalist Calixto Martinez, who broke the story, was arrested on September 16, 2012 by the Cuban Revolutionary Police “for investigating allegations that medicine provided by the World Health Organization to fight a cholera outbreak was being kept at the airport, as the Cuban government were allegedly trying to down-play the seriousness of the outbreak,” according to Amnesty International that recognized him as a prisoner of conscience.
“On 6 March [2013], journalist Calixto Ramón Martínez Arias went on hunger strike to protest against his detention in Combinado del Este prison on the outskirts of Havana, Cuba. He was consequently transferred by the prison authorities to a punishment cell. According to his relatives,the small cell where he is now held has no light, toilet facilities or bedding, and he is not permitted to leave the cell to exercise in the open air. These kinds of punitive measures are typically used by the Cuban authorities against prisoners on hunger strike,” reported Amnesty International on a March 14, 2013 update on his case.
Although Cuban officials declared the Cholera outbreak over in August 2012, 11 months later and tourists visiting Cuba were returning home with the illness. In July 2013 an Italian tourist returned from Cuba with severe renal failure due to cholera. New York high school teacher Alfredo Gómez contracted cholera during a family visit to Havana during the summer of 2013 and was billed $4,700 from the government hospital. A total of 12 tourists were identified that had contracted cholera in Cuba. On August 22, 2013 Reuters reported that Cuba was still struggling with cholera outbreaks in various provinces.
Downplaying a dengue outbreak in 1997
Dr. Dessy Mendoza Rivero
Dr Dessy Mendoza Rivero, married with four children, was arrested on June 25, 1997. The Cuban doctor was jailed for warning about a dengue outbreak, and put on trial with the threat of a 13 year prison sentence. On November 28, 1997 he was sentenced to eight years in prison for “enemy propaganda.” Amnesty International declared Dr. Mendoza Rivero a prisoner of conscience and campaigned for his freedom. He was released on November 20, 1998 “due to health reasons” following the visit of the Spanish Foreign Minister, under the condition that he leave Cuba for exile in Spain. First official report to the World Health Organization of the dengue outbreak was six months after the initial identification made by Dr Mendoza Rivero, and his reports were eventually confirmed.
But the press is not providing this background in its coverage of the current disease outbreak in Cuba, while giving the dictatorship the benefit of the doubt, although Politifact in 2014 observed that “the combination of the Cuban government’s heavy-handed enforcement of statistical targets and the lack of transparency has led some experts to suggest taking the numbers with a grain of salt.”
Worse yet, during the COVID-19 pandemic instead of quoting a medical expert, NPR misidentified a pro-regime propagandist, who wrote Che Guevara: The Economics of Revolution, and held a conversation with a colleague linked to the Tricontinental, a continuation of an initiative that promoted international terrorism, as a neutral Cuba expert commenting on the Cuban healthcare system.
Nobel Peace Prize nominations to propagandize in favor of Cuba’s healthcare system
Cuban medical missions have been nominated for the Nobel Peace Prize twice ( 2015 and 2020 ) and widely promoted through official media, and their agents of influence, but President Donald Trump has also been nominated for the Nobel Peace Prize at least 12 times. One need not be a doctor to get that nomination.
The more important question is how many Cuban doctors, educated and trained under the Castro regime, have been nominated for the Nobel Prize in Medicine over the past 66 years? The answer till now is zero.
Healthcare in Cuba used for reputation laundering
The attempt to judge the quality of healthcare in a dictatorship that lacks transparency is difficult, if not impossible and requires a skeptical approach. Professor Sherri L. Porcelain has taught Global Public Health in World Affairs at the University of Miami for more than 30 years. On September 21, 2017 the Cuban Studies Institute published her article: “U.S. & Cuba: A Question of Indifference?” and the observations she made remain relevant in 2021.
“Investment in the health of people includes protecting human rights. This means allowing the health community to speak out and not to be jailed for releasing information about a dengue epidemic considered a state secret, or not sharing timely data on a cholera outbreak until laboratory confirmation of travelers returning from Cuba arrive home with a surprising diagnosis. This causes me to reflect upon my personal interviews where the remaining vigor of public health actions in Cuba exists to fight vector and water borne diseases. Sadly, however, health professionals are directed to euphemistically use the vague terms of febrile illness in place of dengue and gastrointestinal upset for cholera, in contradiction to promoting public health transparency.”
Why is it that the healthcare systems of Costa Rica, Chile and Canada’s rate higher than the U.S. on international indices, but are not mentioned positively as often as Cuba’s despite the island nation’s health care system rating lower than the United States? Is it because those three countries do not need to set up propaganda and influence operations to justify their existing political systems, because they are democracies with popular support and the regime in Cuba is not?
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 Monday April 18, 2022 premiered a documentary on “The Myth of Cuban Health Care” that is required viewing. Not mentioned in the report is that other Latin American countries ( Costa Rica, and Chile ) rate higher than the U.S. on international indices with regards to their healthcare systems, but are rarely mentioned as models to emulate. Despite Cuba’s unreliable and inflated statistics, its health care system still rates lower than the United States, but that is the system that Senator Bernie Sanders, Angela Davis, and Michael Moore celebrate.
This raises some important questions on the continued praise of the healthcare system in Cuba.
Is it because Chile and Costa Rica do not need to set up propaganda and influence operations to justify their existing political systems, because both are democracies and the regime in Havana is not? The claim that Havana’s situation cannot be compared because it has a hostile neighbor in the United States leads to an obvious question: Why not compare Cuba with Taiwan that also has a hostile neighbor in Communist China? The answer is simple because Taiwan has done a better job on public health generally, and especially during the Covid-19 pandemic.
The documentary also raises the issue of doctors sent out on medical missions creating a positive buzz about the Cuban healthcare system, while some Cuban doctors denounce being trafficked and exploited.
However these international missions have an additional dark side. Mary Anastasia O’Grady in her June 14, 2020 column in The Wall Street Journal warned about “Cuban Medical Brigades to Mexico” and more specifically Havana’s “history of using its doctors to propagandize and build intel networks.”
Cuban doctors sent to Venezuela were ordered to deny or ration care to advance Nicolas Maduro’s election prospects reported The New York Times in the March 17, 2019 article, “It Is Unspeakable’: How Maduro Used Cuban Doctors to Coerce Venezuela Voters,” including the denial of needed oxygen to deathly ill patients.
Anything that does not fit the Cuban government’s triumphalist healthcare narrative has been memory holed.
For example, in January 2010 pictures smuggled out of the Cuban psychiatric hospital Mazorra revealed that patients were dying of exposure to the elements, and had suffered greatly through their time there. Claudia Cadelo, now exiled out of Cuba, wrote in 2010 her reaction to seeing this photos:
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?
Havana was forced to acknowledge what had happened thanks to the still unknown whistleblower and courageous independent journalists who made the images public. The New York Times reported on January 15, 2020 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.”
Three of 26 patients who died of exposure in 2010 in Cuba
Will the myth of Cuban healthcare under Castroism finally be recognized by the mainstream media and the Academy?
‘We are dying’: Cuba sinks into a health crisis amid medicine shortages and misdiagnosis
Hospitals are overwhelmed and fatalities are soaring. The island is suffering from combined viruses that include dengue, chikungunya, Oropouche and other respiratory diseases
Mercedes Interian is unable to hold a glass of water. If she tried, it would fall to the floor. The fever and vomiting are over, the diarrhea and headaches gone. Now that she is out of danger, what Mercedes fears most is that she will be forever stooped. Once a strong 57-year-old woman, these days she cannot take a step without leaning on a broomstick. “We are a hunchbacked people, scratching around for something to eat,” she says, her voice choking due to breathing difficulties as she lies on the sofa of her house in El Cerro, in Havana. “Nobody is okay here, this thing numbs your fingers, ankles, knees… We are an army of zombies.”
Cuba today is indeed a country of sick citizens who do not know exactly what they are suffering from. All they know is that they are being infected by “the virus” – a sinister ghost that has drifted across the entire island, wiping out its inhabitants. First come the high fevers, then red spots develop, or else peeling skin. Vomiting, diarrhea and headaches are inevitable. The hands and knees swell. Victims can barely stand on their feet, and there are those who have not walked again even after the worst is over. A limp indicates a virus survivor. Citizens who drag their legs or complain about achy joints have likely also been hit. According to Maidelys Solano, 38, who was ill at home in Bayamo along with her two children, her father and nephews, every morning in every Cuban neighborhood, people are saying, “It hurts here, it hurts there, today I am a little better, or I could not get out of bed. That’s how all the neighbors are, it’s what they repeat daily.”
Almost all families in Cuba have had someone sick at home due to the country’s epidemiological crisis. The disease is in fact a combination of several mosquito-borne viruses, a model of “combined arboviruses” that includes dengue, Oropouche and chikungunya, as well as other respiratory viruses such as H1N influenza, respiratory syncytial virus, and Covid-19. According to figures published by the Ministry of Public Health, 5,717 new cases of chikungunya were reported in the last week, bringing the number of patients suffering from it to 38,938. As for dengue, the ministry said the disease remains active in the country’s 14 provinces and 113 municipalities.
An alarming 33 deaths were reported at the beginning of the week which the government was forced to recognize, including 21 minors – the demographic most affected by these arboviruses along with the elderly. “There are many one-month-old children who have died, and also those between two and four years of age, as well as other young people, because the vomiting and diarrhea dehydrates them and they arrive at the hospital already in a state of collapse,” a worker at the Institute of Hematology and Immunology of El Vedado told El PAÍS on condition of anonymity.
Cuban officials, who are always reluctant to acknowledge any catastrophe, have been refusing to accept that there is a health crisis, insisting that these are common diseases for the islanders, accustomed to the summer heat and torrential tropical downpours. “They are neither new, nor are they rare or unknown,” Public Health Minister José Ángel Portal Miranda said in October. He then tried to dismiss speculation arising from the countless reports of deaths: “No one can hide an epidemic or the dead,” he claimed.
While the minister was expressing this view, Cubans in the province of Matanzas were complaining about the high rate of infections without knowing exactly what they were dealing with. Now, with hospitals and morgues overflowing, it is difficult for the ministry to ignore the evidence, though many Cubans maintain that the number of the ill and the dead is far higher than the state is willing to acknowledge.
The government has managed to disguise the figures by issuing death certificates that fail to mention arboviruses. “The doctors say that they died of a heart attack, anything but the virus,” says the worker at the Institute of Hematology and Immunology. In Solano’s neighborhood in the east of the country, several people have died in recent weeks. She says that in medical centers they put the deaths down to underlying conditions such as diabetes, pneumonia or hypertension. “But in my town, there are several people who have died from respiratory arrest or dehydration,” she says.
On October 18, Alexander Hernández’s 81-year-old mother felt ill and went to bed to rest. She was completely doubled over. Shortly after, she was taken to hospital and the doctor suspected a case of chikungunya. After a week, she experienced alterations in her diabetes and blood pressure and was suffering tachycardia. “The doctor saw her twice and checked her vital signs,” says the son. A few days later, they said everything was under control, and that she could return home. On November 5 she died. Hernández asked for an autopsy, but the doctor resisted. “He said no, and I didn’t insist because there was no transportation. He practically convinced me that it would be pointless.” His mother’s death certificate states that hers was a natural death.
No medicine or food
Finally, the Cuban government has been left with no choice but to recognize the “national epidemiological situation” that has Cubans in a state of panic. The outlook is so critical that some have appealed to the international community not to let their so-called diseased ship sink with its millions of people on board. While state officials downplay the matter, insisting that it is not an outbreak exclusive to Cuba, and that cases are being reported in Brazil and Colombia, the truth is that the general shortages and state of collapse in Cuba have severely undermined the authorities’ ability to control the disease.
Mercedes Interian says that she is using medicinal plants to self-medicate, because of the absence of prescription drugs in a country that suffers a 70% deficit of medication supplies. She boils water and adds oregano leaves, a clove of garlic, and four cloves – a concoction she drinks in the mornings and evenings. “The truth is we don’t know how to fight it,” she says. “They send you home to rest. We are unprotected in every way. We don’t even know what we really have.”
What worries Cubans most is the lack of proper diagnostic procedures in health institutions that can tell them what type of virus they are suffering from. “For chikungunya, Oropouche or sika there are no diagnostic reagents, only at health institutes in Havana, including the IPK. The doctors write down Non-Specific Febrile Syndrome,” says a nurse from a clinic in Matanzas who prefers to remain anonymous. “To determine if it is dengue, the Immunoglobulin M [IgM] test needs to be run, which tells you the strain. It is not a lie to say that we are dying.”
Solano says that, once you go to hospital, no one tells you what type of disease you have. “If you start to swell, they tell you it’s chikungunya, if not, it’s dengue. Almost everyone has swelling, so most of them have chikungunya. You don’t hear a doctor giving a specific diagnosis. On the certificates they say that you have a virus – always trying to mask the reality we live in,” she says.
EL PAÍS’ source at the Institute of Hematology and Immunology says that many times the results of IgM tests never arrive. “It was reported that they were discarding the samples a lot of the time because there were no reagents to process them, and the patients were given a negative result. There is no such thing as an accurate diagnosis. From the symptoms, it is known that it is an arbovirus.”
Right now, Yudinela Castro Pérez has a scar left by almost 20 stitches that furrows her belly. For the doctors, everything was fine and the symptoms were “normal.” First there was the usual fever, pain, swelling and stiffness. “They told me that I was not the only one going through that,” says the 44-year-old. Then she ate a taro dish and her abdomen swelled to such a degree that she was rushed from her home in Arroyo Naranjo to the Julio Trigo hospital. “They did tests that supposedly came back negative,” she said. Subsequently, she learned that the virus – she’s not sure which – had inflamed her intestine and she had perforations due to silent peritonitis. She has had to buy her own antibiotics and painkillers on the black market, when available.
Several Cubans interviewed by EL PAÍS are concerned that the dearth of good food is damaging their chances of recovery. A nutritional guide to which EL PAÍS had access, circulated by the Pedro Kourí Institute (IPK), reports that, among other things, chikungunya consumes iron reserves, decreases albumin and other proteins, and raises C-reactive protein, all factors that weaken the immune system. According to IPK, a prestigious research center for infectious disease, it is vital to eat eggs, yogurt, whey, fish such as salmon, tuna or sardines, vegetables, nuts and certain grains. Most of these products are inaccessible to most Cubans. “Cubans’ diet nowadays consists of picadillo and rice, and once in a long while a dish made from roots, so it’s impossible,” says Mercedes Interian. “Here, you might not eat any protein in the whole year – only some people can – and without a good diet, the impact of the virus is more virulent.”
The source of the epidemic
The reasons why Cuba became a hotbed of mosquitoes and disease overnight is what many today are trying to figure out. The authorities have come up with the fact that Cuba has a “virgin” population in the face of a virus such as chikungunya, which was discovered on the island for the first time in 2014. They have also attributed the causes to the months of heat and rain that create favorable conditions for the mosquito. Although the country has mobilized forces at the last minute for garbage collection, the fact is the garbage got out of hand due to a lack of government action. And large garbage dumps have fostered a proliferation of mosquito infestations. With daily blackouts, Cuba lacks the fuel to guarantee fumigation. Meanwhile, insecticides are scarce and the lack of water means even minimum hygiene is difficult to attain. The infestation rate, which has become practically uncontrollable, stands at a high risk 0.89%.
Dr. Geanela Cruz Ávila, director of the Provincial Center for Hygiene, Epidemiology and Microbiology of Holguín, told Cuba’s state-controlled news outlet ¡Ahora! that if they had failed in anything, it was in prevention. “In vector-borne diseases, the focus must be on the vector. Without a mosquito outbreak, there is no transmission,” she said, adding that the problem had to be tackled at source. “We can eliminate flying mosquitoes, but if we don’t eliminate the larvae, eggs and pupae, they will continue to emerge and transmit the disease.” Cuban officials believe that with lower temperatures coming, the arboviruses will also decrease. However, they insist on mosquitos being dealt with in the home.
No one escapes the virus
In a country with a collapsed health system, not even the doctors themselves have escaped arboviruses. Those who are still working in Cuban hospitals – 70,000 workers in the sector have quit and more than 30,000 doctors have emigrated in the last three years – “do so with the bare minimum, with almost nothing,” said a nurse from the Matanzas polyclinic, who had the virus and remains in severe pain that will probably stay with her for another six months to a year. According to the nurse, eight clinics closed last month because the staff had been infected.
“Sometimes I read that we are accomplices of tyranny. But it is not like that. This is a profession that we choose because we love it, irrespective of politics. It hurts when you can’t cure the patient and they have to go out to buy their medicines on the street. When we speak out in meetings with the management and the municipality, they just say that there are no resources, because of the blockade.”
At the end of last month, Dr. C. Osvaldo Castro Peraza, a specialist at IPK, said on the official program Mesa Redonda that the chikungunya epidemic “is going to pass” and will soon be history. People are tired of this argument, of the figures being manipulated.
Time will pass and the pain that Matitza Ricardo Velázquez feels as she fights the virus in her home in the municipality of Gibara, will linger. Several days ago, she lost her 42-year-old cousin who was fit and healthy, contradicting the official version that the virus only kills sick elderly folk. “She was strong and full of life,” she says. The day they had to take her cousin to the hospital, the ambulance did not arrive. “Her kidneys began to seize up and the liquid spread through her body. She died in the early hours.” Now she wonders who will be next.
The Economist, August 3, 2022
Graphic detail | Daily chart
Covid-19 has damaged the reputation of Cuban health care
The country’s once-famed health system is in tatters
Aug 3rd 2022
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For a long time Cubans were proud of their health-care system, and justifiably so. Between 2000 and 2020 the small communist-run island outspent most other countries in Latin America and the Caribbean. Life expectancy is higher than in the United States. Cuba has qualified doctors and nurses to spare. When covid-19 first struck, Cuba sent some of its medics to countries struggling with their initial wave of patients. An impressive 89% of Cuba’s population is now fully vaccinated with its homegrown covid jabs—which boast efficacy rates of up to 92.4% after three doses. But according to The Economist’s excess mortality tracker, Cuba has one of the highest estimated death tolls from the pandemic, relative to its size. Where did it go wrong?
Officially, by August 2022 covid had killed 8,529 of Cuba’s 11m people. But our model estimates that the true toll could be far higher. Excess mortality—the gap between how many people have died in a given period, regardless of cause, and how many deaths would normally have been expected—suggests that up to 62,000 Cubans may have died as a result of the pandemic. That 600% increase over the official toll is probably the result of inadequate testing and other problems. It is possible that officials underreported the deaths, too.
Cuba’s estimated tally of excess deaths per 100,000 people is 550. This revised death toll would place it among the 20 worst countries in the world. It would also make Cuba an outlier in the region: the average across the Americas is 368.
Its ageing population—almost 20% of Cubans are over 60, more than anywhere else in the region—made Cuba especially vulnerable to covid. But other factors were avoidable. Budget cuts and a shortage of essential supplies were taking a toll even before the pandemic. After the outbreak hospitals quickly became overwhelmed; oxygen, personal protective equipment and medicines ran short. And although plenty of Cubans are now vaccinated, the country was slow off the mark. Deaths peaked as late as August 2021, during the Delta wave. In that month only around 35% of Cubans had received a full course of covid vaccinations, compared with 64% of Britons and 54% of Americans. The pandemic has brought to light something Cubans have known for some time, but that officials wanted to keep under wraps: the country’s health-care system is not what it used to be. ■
Diario de Cuba, July 2, 2022
Society
In 2021 Cuba registered nearly 200,000 deaths, the highest figure in more than half a century
The country’s population fell by some 70,000, and the deaths of children under one year of age skyrocketed.
By José Luis Reyes
La Habana 02 Jul 2022
After reporting only 8,529 deaths due to Covid-19 between 2020 and today, and systematically seeking to cover up the major exodus from Cuba, the authorities’ falsification of the reality on the island was exposed after the first reports of the Statistical Yearbook, containing figures from between January and December 2021, were released.
In the section of the document dedicated to Population, drafted by the State Office of Statistics and Information (ONEI), it is striking that in the previous year 167,645 deaths were recorded, while the total population fell by 68,380.
Although the decrease in the number of inhabitants has been steady since 2015, mainly attributed to the low birth rate, the downward curve in 2021 was about 7% per 1,000 people.
In numbers, this means that while the country closed out 2020 with 11,181,595 people, at the end of 2021 there were 11,113,215.
These figures could be even more acute if we take into account that in November 2021 an exodus began that, through last May, had seen over 140,000 Cubans emigrate to the USA in what it qualifies as the largest migratory wave from the island in the last half century.
The average number of annual deaths in Cuba over the past five years was 106,813 people, remaining quite stable, with maximum variations of 7,540 cases between 2016 (99,401) and 2017 (106,941), while thereafter it grew by no more than 4,000 cases, such that a major increase in the annual figure could only be due to a health emergency such as the Covid-19 pandemic, which killed millions around the world in the last two years.
In 2021 there were just 99,096 births and, significantly, the numbers of deaths of children under one year of age also shot up, to 753, more than those reported in 2020, when there were 516.
In addition, the decline in births, which according to the Government is a cause for concern and constant attention, was almost 10% compared to 2020, when 109,716 people were born. This fall was the sharpest since 1970, something that is also true for the mortality rate, according to the study.
According to the Yearbook, children under the age of 15 now account for just 15.7% of the population, while 62.7% are aged between 15 and 59, and 21.6% over 59.
Coincidentally, without mentioning the recently published figures, Prime Minister Manuel Marrero posted on his Twitter profile a comment stating: “Demographic Dynamics are a matter of special interest to the Government of Cuba. At a meeting of the Government Commission created to address this issue, we analyzed several points that have a significant impact on it.”
In the summer of 2021, when hospitals were overwhelmed and social media brimmed with complaints of overcrowded hospitals and morgues, as well as the sudden, rushed expansion of cemeteries, and burials in mass graves, the media and official spokespeople strove to deny these allegations, offering absurd explanations.
After a year, the truth has come to light, as well as the authorities’ systematic distortion of the national reality. all to try, unsuccessfully, to hide its botched handling of the crisis.
https://diariodecuba.com/cuba/1656779392_40649.html
Reason, April 18, 2022
The Myth of Cuban Health Care
How did something so at odds with reality persist for so long? And why is it finally crumbling?
Daniel Raisbeck and John Osterhoudt | 4.18.2022 10:00 AM
“If there’s one thing they do right in Cuba, it’s health care,” said Michael Moore in a 2007 interview. “Cuba has the best health care system in the entire area,” according to Angela Davis, “and in many respects much better than the U.S.”
“One thing that is well established in the global health community is the strength of the Cuban national health system,” said Clare Wenham, a professor at the London School of Economics.
Claims like these have appeared in hundreds of documentaries, newspaper articles, and magazine features over the years celebrating the supposed marvel of Cuba’s health care system. It’s a testament to the effectiveness of the Castro regime’s propaganda apparatus that this myth, so deeply at odds with reality, has persisted for so long.
“The Cuban health care system is destroyed,” Rotceh Rios Molina, a Cuban doctor who escaped the country’s medical mission while stationed in Mexico, tells Reason in Spanish. “The doctor’s offices are in very bad shape.”
“People are dying in the hallways,” says José Angel Sánchez, another Cuban doctor who defected from the medical mission in Venezuela, interviewed by Reason in Spanish.
According to Rios, Sánchez, and others with firsthand experience practicing medicine in Cuba, the island nation’s health care system is a catastrophe. Clinics lack the most routine supplies, from antibiotics to oxygen and even running water, and their hallways are often occupied by ailing patients because there aren’t enough doctors to treat their most basic needs. Cuban hospitals are unsanitary and decrepit. It’s exactly what you’d expect in a country impoverished by communism.
The only thing that’s changed is that because of social media and the COVID-19 pandemic, the government’s propaganda facade has finally started to shatter.
And yet in 2021, some journalists were falling for the claim that the Cuban government had set the model in its response to COVID-19. By July of that year, ordinary Cubans had taken to the streets—and to Twitter and Facebook—in part to call attention to what the pandemic had actually meant for Cuban hospitals and clinics.
In the 15 years since the release of Michael Moore’s documentary Sicko, which celebrated Cuban health care, everyday citizens have been armed with smartphones, Twitter, Instagram, and Facebook, empowering them to tell the truth about what it’s really like to walk into a Cuban hospital.
So how did the Castro regime’s propaganda machine manage to fool so many for so long? According to Maria Werlau, executive director of the Cuba Archive, the answer lies with Cuba’s foreign medical missions, which are teams of health care professionals dispatched to provide emergency and routine care to foreign countries.
The first medical mission was sent to Algeria in 1963. After the fall of the Soviet Union, when the government lost its major source of aid, the program was ramped up significantly as a source of revenue for the impoverished nation.
The Cuban government has promoted the missions as a humanitarian endeavor, and a demonstration of the community spirit and selflessness central to the communist project. In his 1960 speech “On Revolutionary Medicine,” the Marxist revolutionary Che Guevara said that “Individualism…must disappear in Cuba.” He recounted the story of a group of physicians in Havana “who demanded remuneration” before going into the country’s rural areas to treat the sick. He dreamed of replacing them with a new class of doctors drawn from the peasantry who would “run, immediately and with unreserved enthusiasm, to help their brothers.”
Rios participated in the medical mission in Sierra Leone in 2013, where health care specialists from around the world came to help contain the Ebola epidemic. The members of the mission were told that when they returned to Cuba, they would be received as heroes. Rios says that, while he did receive a stipend that went to cover his living expenses, medical personnel from other countries were generously compensated.
The myth of Cuban physicians as selfless healers started to fracture in 2000 when two doctors from the mission in Zimbabwe slipped a note to an airline official with the handwritten word kidnapped. They had denounced the Castro regime and were being brought back to Cuba against their will, possibly to face jail time. Instead, they wound up in the U.S. and were granted political asylum.
In a 2020 report, Human Rights Watch said the Cuban medical missions “violate [doctors’] fundamental rights,” including “the right to privacy, freedom of expression and association, liberty, and movement, among others.” It noted that “many doctors feel pressured to participate in the missions and fear retaliation if they do not,” and that “governments that accept Cuban assistance that includes the abusive conditions imposed by Cuba risk becoming complicit in human rights violations.”
In 2006, the George W. Bush administration created the Cuban Medical Professional Parole Program, granting health care workers stationed abroad permanent resident status. All they had to do was make it to a U.S. embassy. Over 7,000 medical workers took advantage of the program.
In 2014, the New York Times op-ed page published an editorial calling for an end to the program. American immigration policy “should not be used to exacerbate the brain drain of an adversarial nation,” it noted. In other words, the rights of doctors to decide where and how to live should be subordinate to what was best for the Cuban government.
After the mission in Sierra Leone, Rios was redeployed to a military base in Mexico. One day, he was sent with a group of doctors to buy some phone cards so they could connect with their relatives back home. He decided to make his escape. Rios found a job at a Mexican pharmacy and started saving money to pay a coyote to bring him into the U.S. He was picked up by border officials, and taken to an immigrant detention center for 42 days. After his release, he could join his family in Miami.
In 2018, a group of Cuban doctors who defected from the medical missions sued the Pan American Health Organization, which is part of the World Health Organization, for aiding in human trafficking and for earning $75 million in fees by acting as a middle man.
The medical missions are primarily a way of selling Cuban health care services abroad. So what’s health care like for those living on the island?
Julio Cesar Alfonso is the president of the Miami-based Solidarity Without Borders, which helps Cuban doctors who have escaped. He says that there are two health care systems in Cuba—one that is used by the majority of regular citizens, and another that is reserved for tourists and the Cuban elite.
When defenders of Cuban health care acknowledge its deficiencies at all, they usually point the finger at the U.S. trade embargo, which has been in place since 1962. But the deplorable conditions in Cuban hospitals have more to do with a lack of basic health care supplies, which are readily available from other countries, such as antibiotics and steroids. Cuban hospitals also have a shortage of beds and stretchers, and some were without water for six to 12 hours a day at the height of the pandemic.
So what impact does the embargo really have on Cuban health care? Medical products have been technically exempt from the embargo since the passage of the 1992 Cuba Democracy Act. But the law does stipulate that U.S. companies need a license in order to sell to Cuba—and critics are correct to point out that this requirement adds red tape to the process. Total U.S. health care products purchased by Cuba from 2003 to 2021 averaged a mere $1.4 million annually, in what should be a $50 to $100 million market. But it’s not the licensing process that accounts for such paltry sales; companies would gladly obtain permission to sell their products to Cuba if they could earn enough money to make it worth the effort. Cuba has a severe foreign currency shortage because it produces little in the way of goods and services that the rest of the world apart from the U.S. wants to buy.
Promoters of Cuban health care often cite the country’s infant mortality rate as evidence of its success. “How is this possible” that “an American infant is, by official statistics, almost 50 percent more likely to die than a Cuban infant,” wrote Nicholas Kristof in a 2019 New York Times column that looked at one of the most often repeated figures in support of the claim that there’s something exceptional about Cuba’s health care system.
While conceding that “the figures should be taken with a dose of skepticism,” Kristof chose to interpret them regardless in support of his priors: “Cuba has the Medicare for All that many Americans dream about.”
Cuba has a variety of strategies for manipulating its infant mortality rate, such as seeing to it that fetuses less likely to survive outside the womb never get the chance. There’s significant evidence that Cuban doctors coerce women into aborting fetuses shown to have abnormalities after routine ultrasounds.
Vincent Geloso, who’s an assistant professor of economics at George Mason University, co-authored a 2018 paper arguing that Cuba’s low infant mortality rate is the result of misclassification using a different indicator known as “late fetal deaths.”
Despite reports early in the pandemic that Cuba was an outlier in its success in combating COVID-19, by August of 2021 The New York Times was reporting that Cuba’s health care system was “reeling,” with oxygen supplies running low, a shortage of syringes, and mortuaries and crematories “overwhelmed.” Cuban President Miguel Díaz-Canel blamed the U.S. trade embargo.
Sánchez thinks that, as the Castros’ health care myth crumbles, ordinary Cubans are beginning to realize that they are not threatened by foreign enemies, as the regime propaganda machine has claimed for decades.
“The only enemy of the Cuban people,” he says, “is the Cuban government.”
Written and hosted by Daniel Raisbeck and Jim Epstein; narrated by Daniel Raisbeck; edited by John Osterhoudt; camera by Epstein, Osterhoudt, Isaac Reese, and Meredith Bragg; graphic design by Nathalie Walker; animations by Reese and Osterhoudt; additional editing support by Regan Taylor; additional research by Alexandra De Caires; translation assistance by María Jose Inojosa Salina; English subtitles by Caitlin Peters.
Photo credits: KRISTIN CALLAHAN – ACEPIXS.COM/Newscom; KEYSTONE Pictures USA/ZUMAPRESS/Newscom; United Nations Photo/Flickr/Creative Commons; Claudio Furlan/ZUMA Press/Newscom; Ipa/ZUMA Press/Newscom; Ipa/ZUMA Press/Newscom; Claudio Furlan/ZUMA Press/Newscom;United Nations Photo/Flickr/Creative Commons; */Kyodo/Newscom; RG72/wikimediacommons/Creative Commons; IAEA Imagebank/Flickr/Creative Commons; Sandrine Huet / Le Pictorium/ZUMA Press/Newscom; Jonathan Alpeyrie/Polaris/Newscom; Angelo Cozzi/ZUMA Press/Newscom; Ernesto Mastrascusa/EFE/Newscom; Eye Ubiquitous/Newscom; Eye Ubiquitous/Newscom; Kike Calvo/ZUMA Press/Newscom; Eye Ubiquitous/Newscom
https://reason.com/video/2022/04/18/the-myth-of-cuban-health-care/
The Washington Post, April 5, 2021
Opinion: Cuba’s powerhouse status comes through repression
The March 31 news article “Cuba could become a vaccine powerhouse” pointed out that Havana wants to soften its image as a “broadly authoritarian country” that has done “some pretty bad things.” Cuban doctors and journalists who raised the alarm in prior outbreaks on the island were locked up and punished.
Desi Mendoza Rivero was arrested on June 25, 1997, for warning about a dengue epidemic in Cuba. On Nov. 24, 1997, he was sentenced to eight years in prison for “enemy propaganda.” Amnesty International declared him a prisoner of conscience and campaigned for his freedom. Dr. Rivero’s claims were eventually confirmed, and he was forcibly exiled.
On Sept. 2, 2016, the Associated Press reported that Cuba had “remarkable success in containing Zika virus.” On Jan. 8, 2019, New Scientist reported the whole story when the facts became known: “Cuba failed to report thousands of Zika virus cases in 2017.”
Repression patterns during this pandemic in Cuba indicate officials seek to downplay covid-19’s severity on the island. According to Duane Gubler at the Duke-NUS Medical School in Singapore, “Cuba has a history of not reporting epidemics until they become obvious,” and that is pretty bad.
John Suarez, Falls Church
The writer is executive director of the Center for a Free Cuba.
April 5, 2021 at 4:35 p.m. EDT
The Wall Street Journal, March 29, 2020
Cuba Avoids an Honest Coronavirus Policy
Some Cuban teachers, ignoring official pronouncements indicating schools would remain open, closed a school. Ministry of education authorities insisted the students are required to attend classes.
March 29, 2020
Regarding Mary O’Grady’s “Repression in the Time of Coronavirus” (Americas, March 23): It is difficult to imagine a worse situation for Cubans. Last month the regime announced that soap, detergent and disinfectant wouldn’t be available for at least two months.
Despite government efforts, Cubans can no longer be kept ignorant of the outside world due to the internet. As a result there have been protests about the handling of the crisis by figurehead President Miguel Díaz-Canel. After announcing Cuba was closing its borders, thousands of tourists fled.
Some Cuban teachers, ignoring official pronouncements indicating schools would remain open, closed a school. Ministry of Education authorities insisted the students are required to attend classes and should bring “a small piece of soap” to school.
The situation continues to deteriorate. Even the Roman Catholic Church is speaking out. A group of nuns and priests released a document calling on the regime to take urgent measures to slow down the spread of the virus including: “That entry of tourism into the country be stopped, that social isolation be decreed,” educational centers be temporarily suspended and that work be done from home.
They also called on the bishops to suspend religious gatherings including masses. In other countries the church has turned to TV and radio broadcasts for the Eucharist, but in Cuba all stations are owned by the regime. Perhaps the new cardinal and the pope could convince Raúl Castro to allow church access to the electronic media now that churches are closed until the crisis is brought under control.
John Suarez
Executive Director
Center for a Free Cuba
Falls Church, Va.
https://www.wsj.com/articles/
The Miami Herald, April 23, 2020
Americans stranded in Cuba by coronavirus events will return in charter flights
BY NORA GÁMEZ TORRES
Americans stranded in Cuba after the government shut down air travel due to the coronavirus pandemic will be able to return to Miami on Friday, the U.S. embassy in Havana said.
The embassy helped coordinate two Delta Airlines charter flights departing Friday morning and already notified those selected to travel. Passengers will pay around $340 for the airline tickets. They were told to expect a full flight and wear a mask since the airline would not be able to enforce social distancing.
A State Department spokesperson said the number of seats was limited. If demand exceeds availability, officials in charge of the repatriation effort will prioritize “U.S. citizens deemed at higher risk of severe illness, followed by U.S. citizen minors and their U.S. citizen parents, or one foreign national parent, followed by all other U.S. citizens.”
Permanent U.S. residents do not qualify for a higher priority but could also fly if there are spare seats, the official said. The embassy warned that U.S. citizens who were not able to secure a ticket for Friday should prepare to remain in Cuba until airports reopen. “We continue to explore options for the repatriation of U.S. citizens who are not traveling on these flights but who wish to return home.
However, there are no additional charter flights scheduled at this time,” the embassy said on Twitter. On March 24, the Cuban government banned the entry of tourists and travelers and ordered Cuban nationals not to travel abroad. On April 2, the authorities effectively suspended air travel, leaving hundreds of Americans, mostly of Cuban origin, stranded on the island.
Many Cuban Americans who are U.S. citizens were not allowed to leave the island even before April 1 because they had acquired permanent residence in Cuba through a process known as repatriation. Most do not live on the island but use that legal status to inherit property or benefit from the public health system.
But that legal status makes them subject to the decisions of Cuban authorities. Some are hoping to get on the Friday flights and return to the U.S. Since Cuba does not recognize the U.S. nationality of Cuban-born U.S. citizens, the island’s government might treat them exclusively as Cuban citizens and may subject them to travel restrictions, the State Department spokesperson told the Herald.
The officials said the U.S. “has advocated for the departure of these Cuban-American dual nationals and will continue to do so.” As of April 19, the State Department’s Repatriation Task Force has facilitated the return of more than 64,000 Americans from 110 countries.
Follow Nora Gámez Torres on Twitter: @ngameztorres
https://www.miamiherald.com/news/nation-world/world/americas/cuba/article242240276.html
Reason, March 27, 2020
No, Cuba Is Not Exactly the Cancer Pioneer Nova Attempts to Present
The myth that this authoritarian island provides better medical treatment just won’t die.
Glenn Garvin | 3.27.2020 2:15 PM
Nova: Cuba’s Cancer Hope. PBS. Wednesday, April 1, 9 p.m.
I feel moved to poetry by the latest episode of Nova, the PBS science documentary science series. Perhaps you remember the classic lines about the little girl with the little curl in the middle of her forehead: “When she was good/she was very, very good/But when she was bad, she was horrid.”
That’s perfect description of Cuba’s Cancer Hope, which is partly an absorbing exploration of the use of immunology in the treatment of cancer, and partly an embarrassingly puffy ode to the Castro brothers’ totalitarian island. Watching it might trigger your latent schizophrenia; or maybe just induce you to write a pleading letter to TiVo encouraging them to get to work on that long-promised button that allows to automatically skip through communist drivel with a single click. Let me know how it turns out.
As recently as the 1970s, researchers who tried to figure out why the human body’s own immune system didn’t attack cancer cells were derided in medical textbooks as believers in witchcraft. (Seriously: Cuba’s Cancer Hope shows an example, a useful reminder to those who think that Science [cap S is deliberate] speaks with one immutable and eternal voice are quite daft.) The prevailing belief was that T-cells and other warrior elements of the immune system would never attack tumors because they were part of the body itself.
The witches—er, researchers—kept chipping at the cancer-as-self theory until scientists in the United States and Japan won a Nobel prize in 2018 for showing that two proteins that act as brakes on immune cells were being tricked into action by cancer cells. If those proteins could be reined in, the conventional wisdom now goes, the human body itself could be a potent weapon against cancer. Cuba’s Cancer Hope, with sharply illustrative prose and graphics, gives a lucid account of this part of the story.
But when the tale turns to Cuba’s development of a lung-cancer vaccine called CIMAvax that enhances the immunological approach with genetic engineering, the show goes off the rails. Cuba, where the national obsession with cigars has triggered a serious lung cancer problem, began experimenting with the drug in the early 1990s. But it wasn’t until President Obama restored U.S. diplomatic relations with Cuba in 2015 after a 54-year break, making it easier for Americans to visit the island, that CIMAvax attracted much international interest.
On the Internet, it quickly acquired the mythic status once held by laetrile, another supposed cure for cancer suppressed by The Man. Several hundred Americans traveled to Cuba to take CIMAvax, and Cuba’s Cancer Hope is full of testimonials from them—tinged with bitter recriminations against the Trump administration for reviving some of the restrictions on travel to Cuba and forcing them to “break the law” to keep from dying. (Actually, seeking health care in Cuba was never on the list of approved reasons to visit Cuba, and would-be patients can get away with it now the same way they did under Obama: By lying about it to U.S. Customs inspectors, who unless there’s an AK-47 in your suitcase, have no way to check what you were doing there.)
Their stories go unchallenged by Cuba’s Cancer Hope. In fact, the only question the show has about anything is, “How is it possible for a county as poor and isolated as Cuba to come up with cutting-edge medicines like this?” The answer, of course, is the resplendent humanitarianism of Fidel Castro, who raised Cuba from a pestilent sinkhole into a model of public health that rivals anything in the First World. Though the United States gets a little credit for imposing that nasty embargo that forced Cuba to become heroically self-reliant.
A much more accurate answer would be: Cuba did nothing of the kind. It was anything but isolated—its top immunology researchers learned their trade at the University of Texas. Its supposed advances in public health under Castro are imaginary; it ranked near the top of Latin America in life expectancy, infant mortality and a variety of health statistics before Castro took power, a fact that PBS once knew. (As for current health-care data from Cuba, about the only person who believes any of it is Bernie Sanders.)
And most of all, CIMAvax is far from a “cutting-edge” medicine. The truth is that it barely works at all. As Cuba’s Cancer Hope admits in a single throw-away line, “Cuban clinical trials show that it extends life three to five months on average.” The five-year survival rate for its users is about 15 percent, roughly the same as that for patients treated with approved U.S. cancer therapies. American oncologists hoot in frustration at patients who want help getting to Cuba to obtain CIMAvax. Says one, quoted in a recent report by Public Radio International: “Without seeing new stats, it’s not that impressive… . I am not too worried about people not being able to go to Cuba.”
Some American medical authorities think CIMAvax shows promise, and a clinical study of the drug is underway at the Roswell Park Cancer Institute in Buffalo. Perhaps it will someday be proven effective. The same could be said of about 200 other clinical studies of various lung cancer treatments being carried out at the moment, but there’s no sign of Nova doing an episode on “Norway’s Cancer Hope” or “The Mayo Clinic’s Cancer Hope.” Of course, none of them would invite any discussion of the genius of Fidel Castro.
Glenn Garvin is a contributing editor at Reason.
https://reason.com/2020/03/27/
New Scientist, January 8, 2019
Exclusive: Cuba failed to report thousands of Zika virus cases in 2017
Health 8 January 2019
THOUSANDS of Zika virus cases went unreported in Cuba in 2017, according to an analysis of data on travellers to the Caribbean island. Veiling them may have led to many other cases that year.
The analysis suggests that Zika infections peaked in Cuba in the second half of 2017, at a time when the virus was waning in mainland North and South America. Cuban authorities didn’t follow the agreed practice of notifying the Pan American Health Organization (PAHO) of the outbreak.
Cuba’s first case of Zika occurred in March 2016. A PAHO report says the country stopped providing updates on Zika in January 2017. In press reports in May 2017, Cuba said that nearly 1900 infections had been detected up to that point. But Nathan Grubaugh at the Yale School of Public Health and his colleagues estimate that the total cases in 2017 alone would have been more than double that at 5700.
“Our results therefore suggest that the 2017 Zika outbreak in Cuba was similar in size to the known 2016 outbreaks in countries with similar population sizes,” the authors write. They declined to comment on the work because it is under review for publication in a journal.
The team looked at the travel logs of 184 people who had contracted Zika while abroad and found that 95 per cent had been to Cuba. Such “hidden” outbreaks can spread epidemics to other countries because travellers and health authorities are unaware of the heightened risk of infection, the authors write (bioRxiv, doi.org/czdk).
The team also sequenced the genomes of Zika viruses retrieved from nine Floridians who travelled to Cuba. This showed that the infection was distinct from Zika infections that occurred in Florida. The travel cases revealed that the strains active in Cuba at the time were related to ones previously detected in other Latin American countries.
The team’s research suggests that the Cuban outbreak seems to have been caused by travellers from nearby countries bringing it in during 2016. It then persisted at low levels, before peaking late the following year.
This is an important discovery, says Duane Gubler at the Duke-NUS Medical School in Singapore. He says Cuba has a history of not reporting epidemics until they become obvious, and Zika is only mildly symptomatic in adults.
“One of the problems we have is that islands that depend on tourism are not forthcoming in immediate reporting,” he says.
Cuba’s Public Health Ministry hadn’t responded to requests for comment by the time this article went to press.
More visible consequences of the outbreak would be appearing now, says Peter Hotez at Baylor College of Medicine in Texas. “It should be possible to detect a blip or increase in birth defects starting around now,” he says. A fetus exposed to Zika during pregnancy risks being born with an abnormally small head, a condition known as microcephaly.
Elizabeth Brickley at the London School of Hygiene and Tropical Medicine says work like this could help fill in gaps in the global disease surveillance system. However, it will still be vital to confirm findings with research on the ground, she says.
Magazine issue 3212, published 12 January 2019
Cuban Studies Institute, September 21, 2017
U.S. & Cuba: A Question of Indifference?
By Sherri L. Porcelain
Professor Sherri L. Porcelain has taught Global Public Health in World Affairs at the University of Miami for more than 30 years.
Eli Weisel, Holocaust survivor, noble laureate and world-renowned author, passionately proclaimed, “We must always take sides. Neutrality helps the oppressor, never the victim.” I chose Weisel’s words to underscore the continuing philosophical and political debate on Cuba’s commitment to its people. I want to be clear; I do not intend to compare past or present acts in Cuba to the Holocaust. Nevertheless, Weisel’s words are persuasive and relevant.
I speak up, in part, as a promise, which I will explain later.
Since its inception, in 1948, the World Health Organization (WHO) has defined health as the state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. Accordingly, health extends beyond the physical to appropriately consider the mental and social welfare of people.
With this in mind, Cuba is promoted as having one of the world’s best approaches to public health. However, I ask this, “Can protecting public health be evaluated positively without embracing social justice and human rights?” Simply stated, these are core international values. The argument that evidence based research supports good health indicators in Cuba necessarily raises more questions. We know safe water, sewage, housing, waste disposal and good nutrition are all basic building blocks of a sound public health system and essential to positive health outcomes. Yet, Cuba’s failing systems have been widely observed and documented today with corroding and leaking water pipes, lack of garbage collection, spillage of sewage and dilapidated insufficient housing along with growing food insecurity.
During the 1980s, Cuba’s commitment to community-based health became the model for primary health care and was highly regarded by many practitioners, scientists, and leaders throughout the globe. Then I was intrigued by David Werner’s analysis questioning if Cuba’s health care system was a model of service or a form of social control [1]
In the mid-1990s a leader in the Cuban Ministry of Health presented at an international public health meeting in Washington, D.C., and he struck a chord with me. At that point, I asked the speaker and wider audience if they understood the depth of the anger and distrust of Fidel Castro’s regime by many Cuban Americans in Miami. Shortly after, Wayne Smith, former head of the US interests section in Cuba, offered a trip by charter flight to Cuban Americans in South Florida interested in an up close look at the public health situation in Cuba. I reached out to colleagues and others from the community with encouragement and a promise that as a Cuban American their participation would not be disclosed. Despite an Alpha 66 threat prior to departure and an empty promise of anonymity, I had to question both sides of the continuing debate.
The aggressive acts from the anti-Castro paramilitary group in Miami vs. the deception of the Cuban government opened a new window of idealism vs. realism for me. After apologizing to those who did not want their names or faces exposed, I questioned how robust was the health data measures presented when people didn’t have access to sufficient food, reliable potable water, soap, toilet paper, nor adequate garbage collection.
The zenith of Cuba’s “special period,” and the 1991-1993 epidemic of optic neuropathy from lack of sufficient vitamins, revealed a weakening society. How could this support the notion that public health was the government’s priority? More recently, I read with great interest Pedro Coutlin-Churchman’s journal article on Cuban Epidemic Neuropathy: A glimpse from inside a totalitarian disease[2] where he reminds us that even with a universal health care approach, the government controlled all food and markets, contributing to the suffering of its people.
Investment in the health of people includes protecting human rights. This means allowing the health community to speak out and not to be jailed for releasing information about a dengue epidemic considered a state secret, or not sharing timely data on a cholera outbreak until laboratory confirmation of travelers returning from Cuba arrive home with a surprising diagnosis. This causes me to reflect upon my personal interviews where the remaining vigor of public health actions in Cuba exists to fight vector and water borne diseases. Sadly, however, health professionals are directed to euphemistically use the vague terms of febrile illness in place of dengue and gastrointestinal upset for cholera, in contradiction to promoting public health transparency.
For years I have expressed a concern about the Cuban government’s refusal to share official public health data in a timely manner. This epidemiologic silence is most disturbing because Cuba has a robust health surveillance system. As recent as May 2017, Dr. Jason Harris, Associate Professor of Pediatrics at Harvard Medical School in an interview with Drug Development & Discovery Magazine remarked that while the Cuban government may not report cases, “there continue to be sporadic cases of cholera in travelers from Cuba,” further revealing a gap in global health diplomacy and security. This is occurring at the same time Cuba receives a top 2017 WHO recognition [3] for their support to international health emergencies, such as their response to Ebola, and other South – South collaborations.
Nevertheless, at home the Cuban government’s repression of rights continues. According to Human Rights Watch (2017) [4] from January to August 2016 there were 7,900 reports of arbitrary detention in Cuba, showing an increase in such detentions in recent years along with other repressive actions. State sovereignty allows for such internal actions, and yet no national or international state or non-state actors seems to be able to change the conversation.
It may take the graphic depiction of dragging, beating, and jailing members of the women’s human rights group Damas de Blanco, dissidents and independent journalists scrolling across a television, computer, or phone screen to reset the agenda, but soon after, unfortunately, the emotional reaction subsides and indifference sets in.
Is it that we remain silent in a noticeable attention deficient disorder world where one big event dominates the 24- hour news cycle until the next one arrives driving a fickle response? Has this become our twenty-first century style of indifference?
As Weisel so powerfully reminds us, the opposite of love is not hate; it’s indifference. The opposite of beauty isn’t ugliness; its indifference.” I suggest, indifference is a powerful word and exposes the perplexity of problems we face today. Yet, we can no longer be indifferent to the human rights violations 90 miles south, and then step up to revere a country for its promotion of primary health care. This is an inescapable compelling contradiction and we must all take notice.
As I stated earlier, I speak up, in part, because of a promise.
In March 2005, the MTV-University program that substitutes a celebrity for a professor, contacted me to bring Eli Weisel as a surprise guest lecturer to one of my classes. It’s been more than 12 years, and with Weisel’s passing on July 2, 2016 it is more important than ever that we speak up about injustices and refuse to remain indifferent. Weisel recounted the harrowing details of the Holocaust and the genocides in Rwanda and Sudan, and his appeal was for us all to address human rights violations, injustices of pain and suffering and to remain vigilant. Weisel encouraged students and faculty alike to not be spectators to an injustice and to speak out by writing letters to newspapers and leaders. This historical survivor then turned to me to request my promise to keep students engaged with these issues, and emphasized “an ethical person is one who is not indifferent.”
Clearly, Cuba is not the only country with documented continuing human rights violations; however, it seems Cuba is one known violator we are willing to overlook to promote the accolades of a free health care system, whether we question this or not.
I intend to keep the promise to embrace the words of Eli Weisel, may he rest in peace. I/we can no longer be indifferent.
Notes:
[1] David Werner (1979) authored Health Care in Cuba: A Model Service or a Means of Social Control- Or Both? Republished in Practicing Health for All, Morley, et. Al, New York, Oxford, 1983
[2] Pedro Coutlin-Churchman, The “Cuban Epidemic Neuropathy” of the 1990s: A glimpse from inside a totalitarian disease, Surg Neurol Int. 2014; 5:84
[3] World Health Organization, May 26, 2017, announces the Dr. Lee Jong-wook Memorial Prize for Public Health to the Henry Reeve International Medical Brigade (Cuba), http://www.who.int/mediacentre/events/2017/wha70/lee-jong-wook-prize/en/, accessed July 25, 2017
[4] Human Rights Watch Report 2017, https://www.hrw.org/world-report/2017/country-chapters/cuba, accessed July 25, 2017
https://cubanstudiesinstitute.us/international-relations/u-s-cuba-a-question-of-indifference/
The Salt Lake Tribune, May 22, 2007
Lowry: Michael Moore’s ‘Sicko’ rehashes tired leftist propaganda
By Rich Lowry
· May 22, 2007
Is all that ails the U.S. health-care system that it’s not run by a communist dictatorship? That has long been a premise of apologists for Fidel Castro who extol the virtues of medical care on his totalitarian island nation.
Left-wing documentary filmmaker Michael Moore is reviving this Cold War relic of an argument in his new movie on health care, ”Sicko,” which premieres in a few weeks and favorably compares the Cuban health-care system to ours. Moore ostentatiously took a few sick 9/11 workers to Cuba for care. ”If they can do this,” Moore told Time magazine, referring to the Cubans, ”we can do it.”
All that the Cuban government has done, however, is run a decades-long propaganda campaign to convince credulous or dishonest people that its health-care system is worth emulating. These people believe – or pretend to believe for ideological reasons – that a dictatorship can crush a country’s economy and spirit, yet still deliver exemplary medical care.
Cuban health care works only for the select few: if you are a high-ranking member of the party or the military and have access to top-notch clinics; or a health-care tourist who can pay in foreign currency at a special facility catering to foreigners; or a documentarian who can be relied upon to produce a lickspittle film whitewashing the system.
Ordinary Cubans experience the wasteland of the real system. Even aspirin and Pepto-Bismol can be rare and there’s a black market for them. According to a report in the Canadian newspaper the National Post: ”Hospitals are falling apart, surgeons lack basic supplies and must reuse latex gloves. Patients must buy their sutures on the black market and provide bed sheets and food for extended hospital stays.”
How could it be any different when Cuba embarked on a campaign of economic self-sabotage with the revolution of 1959? It went from third in per-capita food consumption in Latin America to near the bottom, according to a State Department report. Per-capita consumption of basic foodstuffs like cereals and meat actually has declined from the 1950s. There are fewer cars (true of no other country in the hemisphere), and development of electrical power has trailed every other Latin American country except Haiti.
But the routine medical care, we’re supposed to believe, is superb. The statistic frequently cited for this proposition is that Cuba has the lowest infant mortality rate in Latin America. Put aside that the reflexively dishonest Cuban government is the ultimate source for these figures. Cuba had the lowest infant mortality rate in Latin America prior to the revolution and has lost ground to other countries around the world since. It also has an appallingly high abortion rate, meaning most problem pregnancies are pre-emptively ended.
Other countries in Latin America have made advances in health without Cuba’s vicious suppression of human rights (which, no doubt, contributes to the island having the highest suicide rate in Latin America). The way public health works in Cuba was nicely illustrated by the case of Dr. Desi Mendoza Rivero, who complained of an outbreak of dengue fever that the regime preferred to ignore in the late 1990s, and was jailed for his trouble.
As is always the case with Cuba, anything that’s wrong is blamed on the United States. If there is a shortage of medicine, well, that’s because of the U.S. embargo. But the United States is not the only country in the world that sells drugs. Cuba could buy them from Europe or elsewhere, and the U.S. embargo makes an exception for medicines.
The only reason to fantasize about Cuban health care is to stick a finger in the eye of the Yanquis. For the likes of Michael Moore, the true glory of Cuba is less its health care than the fact that it is an enemy of the United States. That’s why romanticizing Cuban medicine isn’t just folly, but itself qualifies as a kind of sickness.
https://archive.sltrib.com/article.php?id=5961927&itype=NGPSID
Science, July 8, 1997
Dengue Fever Resurges in Cuba
Jul. 8, 1997 , 7:00 PM
An epidemic of dengue fever, a viral disease spread by mosquitoes, is now plaguing Cuba, according to local reports. Estimates of the number of cases range from 838, the last official government number, to as many as 30,000.
The epidemic is testimony to the perseverance of the mosquito that spreads dengue, Aedes aegypti, which virtually every country in the Western Hemisphere has tried to eliminate over the last 50 years, without success. After a devastating epidemic of dengue fever swept Cuba in 1981, claiming 158 lives, the government went after the mosquito with what public health experts describe as paramilitary zeal and soon claimed victory. But now the mosquito has signaled its return with the rising toll from dengue, a severe, flulike illness that can take a potentially fatal form known as dengue hemorrhagic fever. The number of deaths during the current epidemic has been reported variously from three to 20.
International experts say they know nothing more about the epidemic than what CubaPress, an independent news agency in Havana, has disseminated over the Web and the little the Cuban government has made officially available. But Duane Gubler, director of the Centers for Disease Control and Prevention’s division of vector-borne diseases in Fort Collins, Colorado, says he and his colleagues had suspected for some time that a problem was building. As early as the winter of 1996, the Cuban government apparently contacted the international aid group Doctors Without Frontiers, asking for insecticide to kill larvae, plus backpack sprayers for killing adult mosquitoes indoors. By the spring of last year, travelers from Cuba were talking about dengue outbreaks, but until early this June there had been no official confirmation from the government.
Those familiar with dengue and Aedes aegypti aren’t surprised by their resurgence. “The problem with the Cuban program,” says Gubler, “and those that rely on a paramilitary-type of organizational structure is they have no sustainability. Once support and funds dry up, the program falls apart and the disease will come back with a vengeance.” The only hope, he says, is a program in which individual communities take responsibility for clearing out the mosquito–but that has yet to succeed in Cuba or anywhere else.
https://www.sciencemag.org/news/1997/07/dengue-fever-resurges-cuba
Amnesty International, January 30, 2013
Cuban journalist named prisoner of conscience
30 January 2013, 00:00 UTC
Authorities in Cuba must immediately release Cuban journalist Calixto Martínez, currently imprisoned for reporting on issues seen by the authorities as “controversial”, said Amnesty International today as it named him a prisoner of conscience.
Calixto Martínez, journalist with the unofficial news agency Hablemos Press, was arrested by the Cuban Revolutionary Police on 16 September 2012 near Havana airport.
He was investigating allegations that medicine provided by the World Health Organization to fight a cholera outbreak was being kept at the airport, as the Cuban government were allegedly trying to down-play the seriousness of the outbreak.
While at the airport he telephoned his colleagues at Hablemos Press to inform them that he had taken photographs and had interviewed airport workers. He was arrested shortly after.
When he asked the reason for his arrest the police told him they were just following an order.
Even though he was not formally charged or faced court, the police are reportedly accusing him with “disrespect” towards President Raúl Castro and his brother Fidel.
The Cuban state maintains a total monopoly on all media in the country, including television, radio, the press, internet service providers, and other electronic means of communication.
“The imprisonment of Calixto Martínez goes to show that authorities in Cuba are far from accepting that journalists have a role to play in society, including by investigating possible wrongdoings,” said Guadalupe Marengo, Deputy Director of the Americas programme at Amnesty International.
Prior to his September arrest, Martínez had been detained without charge on several occasions in 2012, always in relation to his work as a journalist.
There are currently 2 prisoners of conscience in Cuba.
https://www.amnesty.org/en/press-releases/2013/01/cuban-journalist-named-prisoner-conscience/
Amnesty International, November 20, 1997
News Service 199/97
AI INDEX: AMR 25/41/97
20 NOVEMBER 1997
Cuba: Doctor facing 13-year sentence for “enemy propaganda” should be immediately released
Amnesty International is today calling for the immediate and unconditional release of Cuban doctor and prisoner of conscience, Desi Mendoza Rivero, who is facing a possible 13-year sentence next Monday for using the mass media to spread “enemy propaganda”.
“Desi Mendoza Rivero was detained simply for accusing the Cuban authorities of covering up the true extent of a dengue fever epidemic and of not taking sufficient measures to control it,” Amnesty International said today. “Expressing views which are at odds with official positions is no reason to be taken to court.”
Forty-three-year-old Dr Mendoza, who has been in detention since his arrest on 25 June 1997 and is currently held in Boniato Prison, just outside Santiago de Cuba, was tried in that city on 18 November.
Sentencing is expected on 24 November. The basis of the charge against him was that he had issued statements, which were later disseminated by foreign newspapers and broadcast media, regarding an epidemic of dengue fever in Santiago de Cuba which, according to him, had caused several deaths.
According to reports of the six-hour trial, the prosecution requested a 13-year sentence for Dr Mendoza, who was able to speak on his own behalf for some 40 minutes. His lawyer refuted each of the allegations against him and refrained from requesting a lower sentence on the grounds that in his view Dr Mendoza had committed no crime. When several members of the public applauded the lawyer’s statement, they were removed from the courtroom.
All media in Cuba are state-controlled and dissidents are frequently arrested and imprisoned for speaking out against the government and criticizing its policies.
In 1994, Dr Mendoza founded the Colegio Médico Independiente de Santiago de Cuba, Santiago de Cuba Independent Medical Association, an unofficial organization not recognized by the Cuban authorities of which he is president, and it is believed that the action against him may be at least partly in reprisal for his peaceful activities with that organization. ENDS…/
https://www.amnesty.org/download/Documents/156000/amr250411997en.pdf