Sunday, December 26, 2010

Cuban Medicine Men

What is it that allows Americans to believe the myths about the Cuban healthcare system? It must be that people are desperate to believe that it's possible to keep people healthy without spending a lot -- a lot -- of money.

A Cuban Fairy Tale From PBS What public television didn't tell you about health care in Castro's socialist state

In his memoir covering four years in Cuba as a correspondent for Spanish Television, Vicente Botín tells about a Havana woman who was frustrated by the doctor shortage in the country. She hung a sheet on her balcony with the words "trade me to Venezuela." When the police arrived she told them: "Look, compañeros, I'm as revolutionary as the next guy, but if you want to see a Cuban doctor, you have to go to Venezuela."

That story was not in the three-part report by Ray Suarez on Cuban health care that aired on PBS's "NewsHour" last week. Nor was the one about the Cuban whose notice of his glaucoma operation arrived in 2005, three years after he died and five years after he had requested it. Nor was there any coverage of the town Mr. Botín writes about close to the city of Holguín, that in 2006 had one doctor serving five clinics treating 600 families. In fact, it was hard to recognize the country that Mr. Suarez claimed to be describing.

The series was taped in Cuba with government "cooperation" so there is no surprise that it went heavy on the party line. Still, there was something disturbing about how Mr. Suarez allowed himself to be used by the police state, dutifully reciting its dubious claims as if he were reporting great advances in medical science.

Castro's military dictatorship marks 52 years in power next week. But the "revolution" is dead. A new generation of angry, young Cubans now vents on Internet blogs and through music, mocking the old man and his ruthless little brother. On Nov. 29, in the city of Santa Clara, hundreds of students launched a spontaneous protest when they were denied access to a televised soccer match they had paid to watch. What began as a demand for refunds soon turned to shouts of "freedom," "down with Fidel" and "down with socialism," according to press reports.

Dissent is spreading in Cuba like dengue fever because daily life is so onerous. One of the best documented sources on this subject is the Botín narrative ("Los Funerales de Castro," 2009, available in Spanish only), which pulls back the curtain on "the Potemkin village" that foreigners see on official visits to Cuba. Behind the façade is desperate want. Food, water, transportation, access to health care, electricity, soap and toilet paper are all hard to come by. Even housing is in short supply, with multiple families wedged into single-family homes. The government tries to keep the lid on through repression. But in private there are no limits to the derision of the brothers Castro.

Mr. Suarez's report, by contrast, is like a state propaganda film. In one segment, an American woman named Gail Reed who lives in Cuba tells him that the government's claim of its people's longevity is due to a first-rate system of disease prevention. He then parrots the official line that Cuba's wealth of doctors is the key ingredient. What is more, he says, these unselfish revolutionary "foot soldiers" go on house calls. "It's aggressive preventive medicine," Mr. Suarez explains. "Homes are investigated, water quality checked, electrical plugs checked."

An abundance of doctors? Not in the Cuba Mr. Botín lived in.

In 2006 the government claimed there were 65,000 doctors. That number, he says, was "a figure that many professionals considered inflated." When Cubans complained they couldn't get care, he notes that the state upped the number "magically" to 71,000 five months later. Given Fidel's habit of making things up, it's hard to know how many competent doctors the government has trained. But there is no disputing the fact that thousands of medics have been sent overseas in large numbers to earn hard currency for the regime. There is also no question that Cubans are paying the price at home.

As to doctors checking on water quality and electricity outlets, the PBS reporter might be surprised to learn that most Cuban homes have no running water or power on a regular basis. This is true even in the capital.

In 2006, Mr. Botín says, a government minister admitted that 75.5% of the water pipes in Havana were "unusable" and "recognized that 60% of pumped water was lost before it made it to consumers." To "fix" the problem, the city began providing water in each neighborhood only on certain days. Havana water is also notoriously contaminated. Foreigners drink only the bottled stuff, which Cubans can't afford. In the rest of the country the quality and quantity of the water supply is even less reliable.

Mr. Suarez also reported that, according to Ms. Reed, Cuba is suffering an "embargo of medicine." But there is no embargo on food or medicine. The problem is that the government lacks the money to pay for new medicines that are protected under patent.

Reporters who want access to Cuba know that they have to toe the Castro line. I get that. Mr. Suarez must figure that his American audience does not.

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Saturday, December 11, 2010

Karl Marx and Fidel Castro dying in Cuba

If Cuban leaders really cared about Cuban people, they would convert Cuba into the Norway of the Caribbean. How so? Norway owns vast tracts of oil-bearing territory in the North Sea. It extracts a lot of oil and uses very little. Norway consumes 10% of its North Sea oil production and sells the other 90% to the world, including the US. That money goes a long, long way toward covering the bills of running Norway.

Cuba is positioned to do the same. But not with oil. With ethanol. If Cuba were to meet US demands, the embargo would end and the US would buy its sugar-based ethanol output -- if there were an output to buy.At this point there is no ethanol production. But if Cuba were to re-eneter the world economy and begin the modernization process, an ethanol industry would emerge.

Of course Cuba would first have to get over its self-defeating obsession with Marxism. But after shedding that skin, the island prison would most likely become a state of rising prosperity.

Obama could, if he were not so fearful, bring about this change with relative ease. He could campaign to end the embargo and defeat an enemy government without firing a shot. Seems that's a far better scenario that firing shots and wasting American lives in Afghanistan, where the meaning of winning is unknown.


US cable: Cuba to be insolvent within 2-3 years

Associated Press – Fri Dec 10

HAVANA – A newly released confidential U.S. diplomatic cable predicted Cuba's economic situation could become "fatal" within two to three years, and detailed concerns from other countries' diplomats — including China — that the communist-run country has been slow to adopt reforms.

The cable was written in February, months before Cuban President Raul Castro announced a major revamp of the island's economy, laying out plans to fire a half-million state workers and open up the island to expanded forms of private enterprise.

The cable, sent by the U.S. Interests Section in Havana, which Washington maintains instead of an embassy, was released Friday by WikiLeaks. It was apparently written by America's chief diplomat on the island, Jonathan Farrar.

There was no immediate reaction from the Cuban government, but the cable's release is not likely to help improve U.S.-Cuban relations already strained by the long detention of an American contractor on suspicion of spying — not to mention 50 years of Cold War animus.

It details a breakfast meeting held by the Interests Section's chief economic officer with diplomats from some of Cuba's main trading partners, including China, Spain, Canada, Brazil and Italy, as well as France and Japan, both of which are among the island's top creditors.

"All diplomats agreed that Cuba could survive this year without substantial policy changes, but the financial situation could become fatal within 2-3 years," the cable said, adding that Italian diplomats cited sources within the Cuban government as predicting that the island "would become insolvent as early as 2011."

Even the Chinese diplomat expressed what the cable referred to as "visible exasperation." It said the Chinese were particularly annoyed by Cuba's insistence on retaining majority control of any joint venture.

"No matter whether a foreign business invests $10 million or $100 million, the GOC's (Government of Cuba's) investment will always add up to 51%," the cable quoted the unidentified Chinese commercial counselor as saying.

The Chinese also complained about problems getting loans repaid, and in particular a Cuban request to extend from one year to four years the amount of time it has to repay credit.

It is no secret that Cuba's financial situation is increasingly dire. Raul Castro has warned that the state can no longer afford to subsidize nearly all forms of Cuban life. The government provides free health care and education, and nearly free transportation, housing and utilities. All Cubans also receive a ration book that provides them with some basic food, though not enough to live on.

Most islanders work for just $20 a month in a state-dominated economic system riddled with inefficiency.

Yet the country has survived the collapse of the Soviet Union, which caused the near-failure of its economy, as well as a 48-year U.S. trade embargo, the retirement of revolutionary leader Fidel Castro in 2006 and countless other bumps along the way.

And the cable's confidence that the government would not enact economic reforms did not pan out. The reforms announced by Raul Castro in September are considered the most significant in a generation. Still, it is unclear if they will be enough to save the island's perennially weak economy.

The cable said Cuba's attempts at agricultural and other reform up to that point had been ineffective, and said more changes were unlikely. It said the country seemed determined to give the more control over state-run businesses to the military, and particularly Agriculture Minister Ulises Rosales del Toro, whom the cable described as Raul Castro's most trusted general.

The cable said the situation would worsen dramatically should there be economic or political problems involving Cuba's top ally, Venezuela, which the dispatch said was "increasingly unstable." It quoted the French diplomat at the meeting as saying Hugo Chavez's country "is in flames" and "a source of serious concern for Cuba."

Cuba receives billions of dollars worth of oil a year from Venezuela at greatly subsidized prices in exchange for the services of Cuban doctors and other help.

"There is little prospect of economic reform in 2010 despite an economic crisis that is expected to get even worse for Cuba in the next few years," the cable said, citing Cuba experts. It closed with a scathing criticism of the leadership of a government ruled by aging brothers Fidel and Raul Castro since they overthrew dictator Fulgencio Batista in 1959.

The government's "direction and leadership remains muddled and unclear, in great measure because its leaders are paralyzed by fear that reforms will loosen the tight grip on power that they have held for over 50 years," it said.

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