Last thoughts on Cuba

Cuba was not what I expected.  The third world aspect surprised me.  The people were always helpful, warm and inviting.  Several times their "helpfulness" led us to a friend's restaurant,  a relative's shop, or a request for money to buy milk for their non-existent baby.  I can't imagine living in a place where crumbling beauty is all around and you have to work hard to get enough food to eat.  Where you don't practice the professions for which you trained years and instead opt for the tips of the tour industry as bus boys, waiters and tour guides.

At this stage, the US Embargo seems not only silly, but certainly gives the Cuban people a cause to unite behind--it's an easy target on which to blame all of their problems.  This thinking seems to be encouraged by the Castro government.  Many people in their talks to us requested that we talk to our congresspeople and let them know what the Embargo is doing to the Cuban people.  I wonder if their own domestic policies are most of the problem?

Cuba has a vibrant art and music community that makes me want to know more about the artist we viewed in the Museum of Modern Cuban Art like Mariano Rodriguez, Wifredo Lam, Rene Portoz Arrero and Mario Carreno.   I first saw the Cuban music scene in the movie "Buena Vista Social Club" and there are talented musicians everywhere, playing in bars, restaurant lobbies, and on the streets.

Cuban coffee is a delight and I drank a lot of it.  I really wanted to bring some back, it is forbidden by the Embargo.   I won't miss the sweet evaporated-milk-taste of their cappucinos!

Forgive any mistakes I've made in this writing.  Information came in many ways and I don't claim to have "the truth" about a very complicated social and political Cuba.

Sunset from our room in Varadero

Miscellaneous stuff I think I know about Cuba

Old Havana is 500 years old and the biggest colonial city in the world.   Inside the external doors are beautiful courtyards and cisterns for collecting water during  the rainy season.

Tourism is the number one industry in Cuba with an increase from 1 million 10 years ago to three million last year.

Cubans love baseball and while I was here, Cuba won a playoff game with Japan 6-0. 

Even though we supposedly have no diplomatic relations with Cuba, on the water in the suburb of Miramar is a large building called the American Interest Section.  Fidel built a plaza outside where large concerts are held to annoy the American.  The American put neon slogans on the side of the building.  The Cubans installed 70 flagpoles flying black flags that blocked the view of the slogans.  A truce finally ensued, the music stopped, the slogans stopped and the flags came down, and all that is left is the flagpoles—just in case.

The only sculpture of Fidel in Cuba is on a street corner in Vedado.  Having statues of him was considered anti socialist, but his and many other revolutionary leaders are ever-present in billboard, walls, everywhere. 

All rock music was forbidden and Fidel’s “listening to the people” and realizing that they liked the Beatles resulted in a statue of John Lennon sitting on a park bench.  The Yellow Submarine Café is next door.  This is Jim,  our group director with John Lennon's statue.

The National Hotel, famous in part for a meeting between Lucky Luciano and Al Capone, was used in a scene from  “The Godfather”.

Colon Cemetery is the oldest in the city and has over 2 million residents.  Currently people only get to stay for 2 years and there is an industry removing and cleaning the bones to return to the family—or you can do it yourself.  It is a work of art, and above is one of several funerals going on while we were there for an hour.

Committee for the Defense of the Revolution has block meeting where neighbors get together.  We actually went to a CDR meeting in Santa Maria, but since it was during the mourning period for Chavez, no music, no party, no rum.  Initially these meeting were political and to keep everyone on task for the goals of the revolution, but now, it’s more social and problem-solving and the discussion center more on what color to paint the house and how to keep the streets clean.  The CDR meeting we attended was also attended by the neighborhood doctor and nurse and the people were not only interested in telling us how great socialism is, but seemed genuinely interested in the US and asked all kinds of questions including “is blood banking voluntary in the US?”.

Raul Castro is the president of the last 2 years.  He fought in the Revolution alongside Fidel and Che and his wife was also a revolutionary hero.  Again, their pictures watch over the people.

There are lots of community arts projects that whole neighborhoods participate in.  Below is the director of one of these just outside of Havana that used to be a slum.  Volunteers removed 4 feet of garbage on this corner and a local artist installed the new art instead of garbage for the neighbors to look at.  This area is called Muraleando.   The rest of the neighborhood is full of murals and other art projects by locals.  

The most touted operation in Cuba is the “Miracle Operation” that people come from all over Central and South America to have.  Finally we found out that it’s cataract surgery with a lens implant.

Cuba claims to have extremely low substance abuse and basically no drug problem, but there are addiction programs for alcohol. 

The slaves that worked the sugar cane field have left a legacy of a very colorful mix of West African native beliefs mixed with Catholicism.  Some wear very colorful outfits and the Santeria are dressed in all white and Santerias worship native gods who are disguised as Catholic saints.  Fidel was thought to be a believer and a very superstitious person. Above are some of these colorful women.

The birth rate is Cuba is 1.4

Each municipality  has a cultural center where children are encouraged to participate in dance and music programs.  If kids show talent they are encouraged and mentored to go on to arts schools.  Again, free.  Above are little ballerinas that we watched perform.  So cute! 
Below is the music  project close to Bay of Pigs that we didn't get to hear play because of the "mourning for Hugo Chavez"--give new meaning to the day the music died!

The Wet Foot/Dry Foot policy states that any Cuban who can step on dry ground in the US can receive asylum.

Elian Gonzales is now a 20 year old college student in Cardenas and pro-Fidel.

There is music everywhere.  Mostly older men playing guitars and singing.  This is the port of Coliminar where Hemingway kept his boat, the Pilar.  It was confiscated along with his house after his death in 1961.

The Bay of Pigs is actually a beautiful, turquoise bay! There name for Bay  of Pigs is Giron.

The Cuban story about the Bay of Pigs is very different from the story we learned in school!  Fidel’s strategy was to use as many anti-Batista groups as he could for his cause.  It was only after the revolution that many people realized he was a Communist.  

Internet service is worse than Gambia!!!  By far.

How Medicine works in Cuba

There is one doctor for 153 people in Cuba.  Every neighborhood has a nurse and a doctor.  He/she lives in the neighborhood in a house that has a medical clinic downstairs and home upstairs.  Patients are encouraged to visit anytime.  Above is one of the neighborhood doctor's houses.  Since people don’t move—they live in the family house for generation after generation—and the doctors and nurses know their patients and are expected to visit them at home twice a year.  All medical care and medicine are free and patients are also free to go to the polyclinic which is in the bigger towns or the hospital if they want.   After the revolution, 70% of Cuba’s doctors left for the US and the government gave doctors and other professionals the mansions that were vacated temporarily—most people expected to return to Cuba in 6 months or so.  It’s now been 50 years!  The Ministry of Public Health was created after the revolution.  Private doctors were difficult to access and not all medical services were available.  In his book, History Will Absolve Me, written in prison prior to overthrowing Batista, Fidel laid out his plan for Cuban health care starting with immunizations for all children and adults.  The 1970s saw the increase in medical school, 1980s the family MDs was moved into the neighborhood and prevention was stressed.  The 1990s was a major crisis when the support of the Soviet Union disappeared with the dissolution of the Soviet bloc.  The 2000s saw high tech entering medicine and now Cuba is researching and producing pharmaceuticals.

Cuba also has 39,000 doctors in 110 countries.  Most doctors and nurses serve a 2 year stint as a volunteer in another developing country prior to starting practice in Cuba.  I don’t know how many Cuban doctors have defected to the US. 

Briefly the medical Structure is:

1.        Ministry of Heath that oversees all health care.

2.        13 Research Institutes

3.       Hospitals and 452 polyclinics with doctors according to the population

4.       142 Maternity houses where hi risk, chronic disease, underweight or adverse social situations live full time.

5.       Infant mortality is 4.6 for newborn and 3.5/ 1000 for children under 5 (in 180 it was 27 and 33)

6.       1 RN for 117 people and one dentist for 887 people

7.       36,000 primary care physicians living in the community with the population

8.       26 blood banks

9.       There are medical Brigades that are basically disaster relief team that go to other countries in time of national disasters.  In fact, Cuban disaster teams were the first into Haiti.

10.   Through the Latin American School of Medicine, since 1999 American students can work towards US credentialing

The leading causes of death are the same as ours

1.       heart disease  197/1000

2.       tumors             193/1000

3.       strokes              76/1000

4.       accidents,  pneumonia, and injuries  

All patients are grouped by the doctor and the nurse into

1.        Group one –no disease

2.       Group 2—some risk factors or bad habits

3.       Group 3--- Disease like hypertension or diabetes

4.       Group 4—Post cancer, disability, recovering from an accident

We’ve been to several doctor’s office, polyclinics and hospitals and even though the staff seems well educated and knowledgeable, there is a gross lack of all supplies and equipment.  Most of the places we’ve been predate my nursing career which started in 1971!  Two of our group has been to the international clinic for foreigners for basically the same type of GI disturbance.  One thought they had good care and the other got scolded by the doctor who told her, “you shouldn’t have come to Cuba without medicines”, and acted like she was taking away from Cuban people's limited supply of medications.  

The Importance of being Earnest

There are two Ernests that are revered in Cuba.  First is Ernesto “Che" Guevara, an Argentinian doctor and revolutionary that is worshipped in Cuba. (I read somewhere that his mother was Irish and her name was Lynch.)  He is THE poster child for the revolution and his picture is everywhere.   His handsome image in his black beret with the 5 point revolutionary star hangs in banks, our hotels, side of buses, billboards, newsstands sell book about him.  As our guide said, “Once he was radicalized, he needed a cause to fight for” so he went to the Congo and then to Bolivia, where he died.  In my reading, Che led the last battle that toppled the Batista regime and took command of the military in Havana. He became greatly at odds with Fidel, left Cuba, renounced his Cuban citizenship and was forced into exile by Fidel.   In 1997, Che's body was returned to Cuba and buried close to 37 other guerrillas who lost their lives in Che’s last campaign.  A cult has been built around Che and he is now immortalized as a symbol of the purity of the revolution.  The benefit of dying in your prime when all that can be seen is your potential!

Che was the first billboard we saw leaving the airport.

It is absolutely impossible to walk more than a block without finding Che somewhere.

 Chris and I at Finca Vigia, Hemingway's home outside of Havana.

The other famous adopted son of Cuba  was Ernest Hemingway.  He lived in Havana for several years  and mostly drank and wrote some of his lesser know books. With his royalty check  purchased Finca Vigia, a one story Spanish colonial house with a great view back to Havana about 10 miles from Havana.  There in a little more peace and quiet, he wrote The Old Man and the Sea, A Movable Feast and For Whom the Bell Tolls.  It is now open to tourists, who like me, come to visit the place where Hemingway lived and wrote .  Havana is full of Hemingway places.  He drank his daiquiris at El Floridita—he also immortalized both the drink and place in Islands in the Stream-- and his mojitos at La Bodeguita del  Medio where he brought the drink  instant fame.  Both clubs continue to trade on Hemingway and you wade through sweaty, rum soaked people and a haze of cigarette and cigar smoke to drink like “Papa” did.  I actually waited in line to see his old hotel  room 511 in the Hotel Ambos Mundos.   The Cubans are still in love with Hemingway.  He is required reading in schools  and Fidel said that For Whom the Bells Toll inspired his guerilla tactics.  Upon his death, his 4^th wife was forced to sign over Finca Vigia and most of the contents to the Cuban government as well as his boat.  Hemingway loved Cuba back and called it his home for 20 years until he had to decide between the US or Cuba.  

Jobs in Cuba

Cuba is full of doctors and nurses.  There are 15 provinces and each has at least one medical school.  Doctors and nurses are paid about 80 to 90 CUCs a month (1 CUC = 1 USD). This is the same salary that most teachers and government workers make. Tour guides, restaurant workers make minimum wage, but get tips  that allow them to make salaries of 200-300  CUCs a month and  put their salaries ahead of most professionals.  The best job in Cuba now is to work for an international company where the monthly pay is 600-900 CUC.  With the loosening of laws within the last 2 years, it is possible to rent out a room in your house which can bring in $300/month.  

Another change since 2 years ago, 180 jobs are now open to do privately, but a person can only emply 5-10 people.

Above right--barely in the picture is our guide, Arturo, with 2 of the doctors at a local clinic.  Arturo was a professor of English at Havana University.  He now leads tours like ours since the money is so much better and it's paid in CUCs.  Most of his income comes from tips from people like us!

Hugo Chavez died today.

Venezuelan dictator Hugo died today.  The state has announced that there will be three days of mourning with the “official mourning day” as Friday since that is the day of his funeral.  Thousands of people stood in a long, meandering line around Revolution Square to sign a book of condolescenes from the people of Cuba to the people of Venezula.  Havana is a city filled with music of all kinds and the music stopped.  The government  forbid all concerts, music entertainment in hotel, clubs or any other venue.  The opera, the ballet—nada. Flags are flying at half mast. 

 Chavez had left Cuba a couple of weeks ago to finish his chemotherapy at home in Venezula, but most people suspected he was dying and even though the TV and newspaper showed Chavez in bed surrounded by his two daughters, he has never taken the oath of office after the elections last fall.  Yesterday, we did hear that he was having respiratory problems and that he might be sicker than people were led to believe.

Fidel and Chavez are good buddies and have not only a philosophical agreement as far as running a socialist/communist dictatorship, but Cuba gets oil very cheap from Venezula and  in exchange, Cuba provides doctors and nurses to Venezula.  There is some concern about the preferential treatment they received about their oil—like maybe the new president won’t continue to honor the agreement.

 

 

Cuba's dual currency

Cuba has a dual currency.  Foreigners use  CUCs.  1 CUC = 1 US dollars.  When we exchange we get .87 CUC for one dollars even though it’s based on the US dollar! Guess it’s their little revenge against the US!  Better to take Canadian dollars, euros, or English pounds.  The Cuban used to use Cuban pesos in addition to using the newer CUCs.  When this dual currency started 1 CUC was worth 120 pesos and now 1 CUC is worth 24 pesos.  The goal seems to be to get the CUC to equal 1 cuban peso and then shift to CUCs for Cubans and foreigners. 

Old American Cars are Everywhere

The only cars you see in Havana—in fact, all of Cuba, except for the occasional old Soviet made Lada and rare new South Korean car, are American cars built prior to 1959 during the heyday of big, confection colored gas hogs.  Cuba was an exciting destination from the 1920s until the Revolution in 1959.

The first private job—2 years ago under reforms instituted by Raoul Casteo—were taxi drivers. The train is not at all reliable and not used due to no schedule, and the buses are very crowded and nowhere near what is needed to transfer people around Havana or anywhere else.  These old cars carry 4-6 people for 50 cents to 1 CUC each.  This makes driving a taxi a fairly lucrative job.  As more and more taxis were needed, 1956 Chevy Bel-Airs and 1959 Impalas came from other provinces to Havana.  The result is that Havana is a constant parade of old American cars in every color imaginable!  Some are fixed up and some are pretty dilapidated.  The government doesn’t allow cars to be sold and the only cars that can be traded are the old American cars

Romero and the literacy campaign

We had a short talk by Romero last night.  He is 64 years old and recently retired as an electrical engineer.  Hi wife is a chemist and will have mandatory retirement in 6 months at age 60.  Their pension per month comes to about 13 CUCs.  This is the government’s plan to provide jobs for young people.  Romero was 12 years old in 1961 shortly after the revolution. Out of the 6 million Cubans at that time, only 1 million were literate.  Castro had an ambitious plan to make all of Cuba literate in one year.  To accomplish this, young people of 12-15 were sent to a 2 week training program to teach people to read and write.  Romero was sent to a mountainvillage about 600 miles from his home and was given 4 people to spend the next 9 months living in their home, helping with the farm labor and teaching them to read and write after farm chores were done.  He was successful as were most of the young people and at the end of the year, 99% of Cuba was literate.  That high literacy rate has been maintained over the last 50 years.  Schooling continues to be free—from kindergarten thru college.  Each of the 15 provinces has a medical school which is free also.  There are exams, but if you can get in, the cost of your education is paid. 

After 2 years of looking for houses, I have to say that Havana has “great bones”!  It is so obvious that it was a beautiful, rich city at one point.  Now the decay is everywhere—building look bombed out, grass is growing out of the side of walls, streets are broken full of potholes.  The general run down appearance of everything is accentuated by an occasional restored building.  China has now given Cuba billions of dollars to work on their infrastructure and to fix up old Havana.  Around the center of town, scaffolding encases a few of the buildings.  The biggest surprise is the lack of anything in the stores.  The shelves are almost bare.  Meat cases are empty.  People have ration cards and we see them standing in long lines for bread at the bakery, eggs at another store and beans and rice and rationed.  The rations aren’t’ really enough to feed the people but people look well nourished and are certainly not going hungry.  The stores that I have been in will have a few chicken breasts selling for a price that the ordinary person couldn’t afford.  A small box of juice was 2.50 CUC, a bottle of olive oil was 13.5 CUC, but a bottle of rum costs 3.50!

Day 2 Havana and Land ownership

Up early and off to Miami airport for the 50 minute flight to Havana. Cuba now gets 3 million foreign tourists yearly—counting Americans like me.   I’d been warmed that the whole process of getting from the US to ‘Cuba was one big hassle.  I really didn’t think it was any worse than many other travel experiences that I’ve had—but compared to being deported, this was nothing!  By the time we finished passport control and everyone got their luggage, off to lunch at a beautiful old mansion in a restaurant called El Patio.

Now the hassle came at the hotel when our rooms weren’t ready and then they gave Chris and me one bed.  The bed mistake was good because we were upgraded to a much bigger and better room with a balcony overlooking Prado Paseo de Marti, one of the main arterials thru Havana with a wide green space with large trees in between.   Most people walk instead of driving and the street are not congested and no pollution.
Walked from our hotel along Obispo St. out to Havana Harbor and meandered back through windy streets to our hotel.  Havana is 500 years old and several archaeological digs are going on.  But mostly I’m amazed by the beautiful colonial architecture everywhere including our hotel, the Parque Central.  Some have been restored, but many are standing solidly without windows and door waiting for renovation and a few are in the process. 

Dinner was at Ivan Justo, a chef who started his own restaurant over a beauty salon.  Raoul Castro changed the laws to allow some free enterprise and there are starting to be more and more privately owned restaurants as opposed to the government restaurants.  Private restaurants are clearly marker with the word “palador” on the door.  Even in restaurants and hotel, English is technically spoken, but certainly not what we’ve become accustomed to where almost everywhere in the world, it is easy to find someone who is fluent.  Our waitress was very patient to get our order, but taught me to say, “rojo per me, y blanch per ella”  (red for me and white for her)  Our dinner was spectacular.  The biggest lobster that I’ve ever seen complete with tentacles hanging over the platter cut in half and grilled with roasted vegetable.  

Streets are dark, full of potholes and not street you would even enter at home.  Maybe one street lamp a block, the stores are almost empty of food.  One store we passed on our way home had just a few things on shelves, but large Costco-size cartons of eggs.  Women were standing in line to buy eggs!  There is a food ration program for the Cuban people.   Newborn babies are registered with the state and they start receiving ration books which allows every person 6 pounds of rice per month.  Many other foods such as coffee, milk, sugar, and bread are rationed.  This costs the Cuban government 66 million dollars a month.  Sounds like there has been off and on communication between the US and Cuban government.  When no planes could land in the US after 9-11, Cuba offered to let planes land in Havana and shortly afterward, US food products such as corn, oil, wheat, dry milk and chicken were sent to Cuba.  Feeding its people seems to be an ongoing struggle for Cuba.  After the Soviet Union fell in 1989, Cuba was plunged into a severe recession that took years to recover from.  During this time, power was on for 8 hours a day and people ate anything to survive the lack of food.  The Cuban export business dried up since sugar, their major crop at the time was only exported to Russian.  The government has made attempts to diversify the crops being grown and to diversify who is buying them!  Coffee, tobacco and rum are now their big exports. 

Since I’m on the subject, land and agriculture has undergone a huge transformation in the last couple of years.  After the Revolution that brought Fidel Castro to power, land was taken away from the landowners and given to the peasants.  Many, many Cubans fled Cuba during this time.  If you left your land, it was also taken away and given to other families who needed a place to live and farms became part of large state farm.  Many of the old mansions had 3-5 families living in the house formerly occupied by one family.  The houses belonged to the government. Castro implemented the 2^nd Agrarian Reform in the early 1960s. This affected mostly the tobacco farms.  Cooperatives were formed and you could either keep your land or pool with others to create a coop.  All goods were sold to the government.  This is also a country that gets about 20 hurricanes a year with the western provinces being harder hit. 

 

A legal trip to Cuba

Chris and I left SEA on a red eye for Miami Thurs night.  I’m too old for these flights.  A little rest and off to explore Miami.  Jim Lewis, RN left ICU nursing and now lead trips to Cuba to research the Cuban health care system.  Ok, what does that mean?  Don’t quite know but Chris and I have two bags of supplies from our work, like latex gloves, scissors, hemostats, tourniquets, and lots of other stuff that we throw out.  Also both of us made trips to the Dollar Store for crayons, colored pencils, pencil sharpeners,  aspirin, ibuprofen, band aids and other gifts to give out.

 

Jim Lewis, our leader was waiting for us in the hotel lobby and had arranged a tour of Miami for the afternoon and dinner at the Versailles, a Cuban restaurant in Little Havana before we could get to bed and some needed sleep!  The bus tour took through neighborhood rich and poor, but mostly rich.  Coral Gables, Coconut Grove and South Beach with its pastel art deco building and sidewalk dining.  Lots of man- made canals and exclusive neighborhood.  Miami is the site of movies, TV shows, celebrity residences, mob haunts and lots of sunshine. It’s also incredibly green, warm and humid.

 

The group, 15 in all is the usual varied assortment of people.  At dinner, I chatted with a mother-daughter duo, neither are nurse, but both are interested in Cuban healthcare.  To be able to legally go to Cuba, one needs a reason and we were given those reason in writing this morning, which are “data collection among Cubans who agree to be interviewed in both urban and rural environments”.  Anyway, back to travel mates.  Mother is a bit younger than I and has lived off the grid for 30 years with her husband, whom she describes as an old hippie.  They built a house by themselves in the Gold Country of California.  She said life got much better after they dug their fourth well that actually supplied enough water to take a shower and run a pot of water at the same time!  All power is provided by solar panels on the roof.  She said 28 of the 30 years has been an exceptional experience.  Two years were spent living somewhere else with 2 small children while her husband finished up the house. 

 

Early Friday morning, we’re off to Miami airport for the 50 mins. flight to Havana on Skyking Airways.  American Airlines also makes scheduled flights to Havana.  For a country with no diplomatic ties and the US has had an embargo against for 50 years, there is lots of travel between the two countries!!