by Pat Turnbull

Sixteen of us from Britain went on the Cuba Solidarity May Day study tour to Cuba.  At Havana Airport on the way back the toilets were blocked and there was no water supply.  Not pleasant for the travellers – even worse for the Cubans who would have to unblock them.  When we arrived at Gatwick the toilets were working.

But what did Cuba have that we don’t have here in Britain?  We found that out on our thirteen day visit to the socialist island in the Caribbean, ninety miles from the USA. 

One of Fidel Castro’s first announcements after his triumphal entry into Havana in 1959 was that the army barracks of the dictator Batista would be turned over to become schools.  Our first visit was to the Abel Santamaria School for the Visually Impaired in Havana, which is part of this spacious school complex set in grassy tree lined grounds.

Some 57 pupils of all ages from all over Havana go to the school. 44 are day pupils, 9 are boarders, and 4 are in workplaces.  All the pupils study the same curriculum as the rest of the school population: maths, Spanish, history, English as a Foreign Language, science, civic education, labour education, computer science.  They have aids to help them, and special additional classes relating to their disabilities to help them in their future life.  There are paediatric and ophthalmological services, psychiatric help and language therapy.  Some pupils have additional intellectual disabilities.

The school works 24 hours.  There are 47 teachers of whom 35 are masters in special education.  Others are finishing university diplomas and PhDs.  All their studies are free – lifelong education is free for everybody in Cuba.  The staff is very stable with an average age of 40.  The job is very rewarding; we were told how beautiful it was to see them learning the same subjects at the same time as other students, to see them start work at the same time.  Pupils visit their old school and say thank you.  Not only beautiful for them, but beautiful for society.

The teachers also do outreach work to support the 94 additional students who are in the general education system, right up to university, where 18 former pupils are currently studying.  They train other teachers how to teach them and provide the necessary additional educational equipment.

We visited the Federico Engels School later in our trip, also a well designed school in plenty of space.  It was opened on January 27, 1978 by Fidel Castro and has a collage of photos of him in the hall.  2,500 students aged 15 to 18 study there; it is a vocational pre-university school for the sciences.  The school has 274 workers of whom 125 are teachers.  There are more girls than boys at the school, and we were reminded that most of the top scientists of Cuba such as doctors are women, and that women make up 53 per cent of the Cuban national parliament.  We were also told that cleaning brigades of students clean the school, and that the uniforms worn by all students are available at nominal, subsidised prices.

The school was built in three years, along with hundreds of others, despite the US blockade and the limited resources.  500 smaller secondary schools in the countryside were also built.

From visits to the Cuban Institute of Friendship with the Peoples and the Cuban Workers’ Confederation (their trade union congress) we learned more about Cuba.

CUBAN INTERNATIONALISM

Cuba sent fighters to help the people of Angola win their freedom.  Cuba took away nothing from Southern Africa except their dead soldiers, more than 5000 of them.  Cuba is a poor country and their only wealth is the Cuban people – they can’t export money or raw materials.  But they offer to their friends their people, and they give it generously, in the form of doctors, teachers, literacy programmes, health care.  Cuba has 50,000 workers in 64 countries of whom 25,000 are doctors.  The Latin American School of Medicine in Cuba has produced 20,000 graduates from everywhere, including students from the USA who could never afford to study in their own country.

The illegal blockade by the USA hinders trade not only with the US itself, but with other countries who would trade with Cuba - like Nigeria, as we later found out, who would like to benefit from Cuba’s cheap medicines and favourable trading agreements.  Foreign banks have been fined.  Cuba produces nickel, one of its few raw materials, but if a product contains more than five per cent Cuban nickel, it cannot be exported to the USA.  The lack of hard currency affects imports of raw materials, tools, some foodstuffs.  The blockade forces Cuba to move away from the Americas to far continents.  They pay triple the prices to import certain medicines because of the blockade. 

When the USSR and the other socialist countries went down in 1990, Cuba lost more than 85 per cent of its trade.  Previously the socialist countries had paid prices for Cuban sugar and other products well above the exploitative prices offered by the leading capitalist countries.  Cuba had to adjust in a cruelly short time, and go through the ‘Special Period in Peacetime’.  Cuba’s buying capacity shrunk from 8.139 million pesos in 1989 to 2.0 million in 1993.  To make matters worse, in mid 1992 the Toricelli Law passed by the US government gave the US President the power to apply economic sanctions against countries that have trade relations with Cuba, and prohibits trade with Cuba by subsidiaries of US companies located in third countries.  This law was a clear attempt to bring the Cuban people to their knees through hunger.  

But Cuba has adapted and survived. In particular, they had to reformulate their policy on sugar where now the cost of production did not match the international price.  Land was turned over to other products.  Whole towns had been built around sugar production, so there was a big cultural problem.  People were sent away on courses, to learn to produce other things – vegetables, fruit, preserved foods, most of it organic.  Largely the communities were re-orientated and preserved. 

The Cuban economy is now run mainly on rum, cigars, nickel, cobalt – and tourism.  Cuba was forced to think of tourism as a source of income in the 1990s, and open up to foreign investment.  It has also extended its private sector, whose role is to support public provision – 47 per cent of the state budget goes on health, education and social security.  Previously Cuba had no history of taxation, most of the product being used directly to provide services.  Taxes on the private sector are still low, however, to motivate the sector.  Private sector workers have the same legal employment rights as those in the public sector.

Cuba has strict anti-drugs laws, and for good reason.  The country is caught in the middle between the main client – the USA, ninety miles to the north – and the main producer, Colombia, to the south.  A priority is to prevent the country from being the drugs haven it was under Batista, and to protect society, and the youth in particular, from the harmful effects of drugs.  As well as severe legal measures, Cuba has community based group addiction therapies, mainly to combat the effects of alcoholism.  In one polyclinic we visited, two of the three psychiatric therapy groups were for alcohol addiction.  For more on this issue, there is an excellent book Drugs and Lies – two aggressions against Cuba by Juan Francisco Arias Fernandez, Editorial Capitan San Luis, Havana.

HEALTH CARE

Cuba’s second great achievement, as well as free universal lifelong education, is free and universal health care. There are four elements in the Cuban health system: promotion, prevention, cure, and rehabilitation.  Family doctors are the basis of all this.  They live in the community and know every household, all the home conditions, the state of hygiene, the risk factors for families and individuals.  They classify patients in four categories: healthy, risk factors, sick, and severely sick or disabled.

In the small town of Viñales we met Dr Frank and Nurse Sandra, who both come from and live in the town.  They have another doctor and nurse in the practice.  There are 22 doctors in Viñales, one for every 700 inhabitants. The doctor’s surgery runs from 8 till 12; there’s an hour for lunch, and then until 5 the doctor mainly makes home visits.  One day a week there is a surgery till 8.00 p.m. and on Saturday it is open till 12pm.  The doctor sees about 10 – 12 patients per day, mainly in the morning.

The Viñales polyclinic works 24 hours, and there is a hospital in the nearest large town of Pinar del Rio.  At the hospital there is a social workers’ department.  When a patient leaves hospital he or she receives a discharge certificate, and a social worker follows up with home visits.

Doctors and nurses can attend continuous upgrading courses which, like all education in Cuba, are free.  A masters or PhD increases their wage.

We also learned from our visit to the family doctor that maternity leave in Cuba is a year on full pay.  There are day care centres for pre-school babies and children which are very cheap – 2 CUCs (Cuban convertible pesos), less than £2 per month.  Schools run till 4.30 or 5.00, and pedagogical assistants run free after school programmes after that.  Sick pay in Cuba is 70 per cent of full pay.  80 per cent of medicines used in Cuba are produced by Cuba itself.

Polyclinics are the next stage up in the Cuban health service after the family doctor.  We visited two.  At one we learned some Cuban history: in 1959 there were 6,286 doctors, solely in the towns and in private practices.  Infant mortality was 60 per 1000 live births.  Life expectancy was 60.  There was only one medical school.

In 2017 there were 90,161 doctors, 46,302 of which were family doctors.  Infant mortality was 4 per 1000, life expectancy 78.45 years.  There were 13 medical schools and two independent faculties.  There is 100 per cent cover of all rural and urban areas.

The Polyclinic ‘Luis August Turcios Lima’ covers 45,442 people, including five People’s Councils.  It has 823 workers of which 211 are doctors, 192 nurses and 34 dentists.  There are three basic working groups each with 15 family doctors.  There is also a day care centre for 40 elderly people open from 8am to 5pm to look after them while the family is at work.

The clinic also has 86 collaborators from 13 countries: 42 from Venezuela, 25 from Brazil, plus others.  53 of them are doctors.

We asked about salaries and found out that a family doctor earns 1,400 pesos per month, and a nurse 900.  We were assured that there was no shortage of mental health beds for severe cases.  The Psychological Hospital in Havana has 800 patients.

The key to Cuban health is to give attention to patients at community level, to offer universal care at that level, thus avoiding congestion in hospitals.  The justified pride in Cuban health care was expressed in the words: ‘Our primary health care has no comparison’ and perhaps a little sharply: ‘Maybe the hospitals here are not as beautiful as yours, but we care about the people.’

We visited the Republic of Chile Cooperative Farm in Viñales and were greeted by the President of the Board, a parliamentary representative of the farmers.  This cooperative was created by Fidel Castro on October 6, 1973.  On September 11, 1973 President of Chile Salvador Allende died heroically, fighting the coup d’etat; that is why Fidel proposed the name.

The farm produces tobacco, beans and root veg, fruit and other products.  It has 50 members, 39 men and 11 women, and a directive board elected every two and a half years.  It has an assembly every month and any decision passed by 50 per cent plus one vote is binding.  The farm also has a primary school and a secondary school, which together have 128 students, a family doctor, bakery, shops and a barber, provided by the state.

Each worker makes a profit on what he or she produces.  The profit corresponds to the individual or semi-collective effort of the workers and their efficiency.  The farm has operated on this basis for fifteen years after it was approved by the assembly, and it has yielded good results.  The farm produces mainly organically, with biological control of pests.

The average age of cooperative members is 54, and retaining young people is a problem.  Farm work is hard in the tropics and the young don’t like it.  Study in Cuba is almost compulsory, the president told us, and the young very often don’t return, even though they go to agricultural college, and even though agriculture is well paid.  Cuba subsidises health, education, social security, electricity and transport – it cannot afford to subsidise agriculture as well.   

Mechanisation was going ahead with equipment from the Soviet Union, and when the socialist countries disappeared, it was like the apocalypse.  Farmers had to start using the old methods again, like ploughing with oxen, which luckily many farmers had kept.  There was a lack of fertilisers until they saw they could produce their own, and also produce food for the animals.

There is a project for solar energy with a state company; the farm has given over eight hectares of land to them.  The aim is to provide electricity to the national grid.

The president told us about another problem that has got worse for Cuba – hurricanes.  Last century in a hundred years there were only four or five bad hurricanes.  In the past eighteen years there have been fourteen.  Last year Hurricane Irma destroyed agriculture and damaged thousands of houses, surgeries, factories and farms on the northern coast when it hit.  ‘But we will never be defeated!’ the president said.

They have a housing problem in Cuba.  90 per cent of Cubans own their own homes, so high rents are not an issue.  However, there are not enough homes and almost 40 per cent of them need repair.  Getting materials for restoration and repairs is a big problem, particularly because of the US blockade.  But, unlike London, Havana has no homeless people sleeping on the streets.  And unlike other poor countries, it has no shanty towns either.

FEDERATION OF CUBAN WOMEN

Our last visit was to the Federation of Cuban Women, one of Cuba’s many mass organisations.  The federation was created in 1960 – on August 23, 2018, it will be 58 years old.  There is a federation organisation in every one of Cuba’s 168 towns and 15 provinces.  There are 81,000 grass roots organisations.  This is how the federation learns the different problems of women in different places; they visit women in their homes.

The federation has more than 4 million members, nearly 91 per cent of women 14 years old or more.  It is self-financing with a subscription of 3 Cuban pesos a year (15 cents in dollars), but even that is waived if you can’t afford it.  The federation gets no money from the government; it is an NGO, but not one against the government, because the revolution has given women the possibility of development.  Women in Cuba have physical, economic and political autonomy.

Despite the many ways in which Cuban women are supported, there is a falling birth rate.  The federation proposed that there should be a modification in maternity leave so that it could be taken by the mother, father or grandparent.  This was adopted in 2017.

All these are the achievements of Cuba – things to remember if you have to call the man with the plunger because your hotel toilet is blocked, or if you think the room is scruffy, if you find the food a bit samey, or if you get bored with people muttering ‘Taxi?’ as you go by.  Your CUCs (Cuban convertible pesos) are contributing to keeping a little beacon alight in the Caribbean.

And our group was privileged to celebrate the first of May, Workers’ Day, with 1.6 million residents of Havana in Revolution Square, watched over by Jose Marti, Che Guevara and Camilo Cienfuegos, and under the slogan ‘Unity, Commitment, Victory’.  As Rob Miller of Cuba Solidarity said at the post May Day International Solidarity Conference: ‘Cubans should be very proud – we are very proud of Cuba.’  And as the Cuban speaker said: ‘They have the power, but we have the truth.’

 

Miguel diaz-Canal (58) who succeeded Raul Castro as Cuba's President of the Council of State and the Council of Ministers on 19 April 2018. Before that he served as Higher Education Minister and Deputy Prime Minister.

"...in 1959 there were 6,286 doctors, solely in the towns and private practices. Infant mortality was 60 per 1000 live births. life expectancy was 60. There was only one medical school.
In 2017 there were 90,161 doctors, 46,302 of which were family doctors. Infant mortality was 4 per 1000, life expectancy 78.45 years."

Calixto Garcia University Hospital in Havana

In 2017 the hospital carried out over 3,500 surgeries of which, 1,500 were scheduled surgeries, said the head of the Orthopedic Service, Dr. Juan Diaz Quesada. Dr. Diaz Quesada highlighted the advances of emergency and scheduled traumatology surgery. an average of 2,000 patients in 2017 were treated in the hospital's emergency ward in addition to 700 outpatients.
(From the Cuban News Agency [ACN] - 24 Jan 2018)