Saturday, 26 November 2016

Remembering Cuba

"You will know them by their fruits. Grapes are not gathered from thorn bushes nor figs from thistles, are they?”  

Can we talk about what Fidel Castro left behind?  

 A country with a HDI of 0.769 and ranked 67th of all countries, with the trend towards this HDI increasing since 1990 and retaining the level over the last few years.  And this despite the US embargo.  And the dismantling of the Soviet Union and the end of the Cold War. And yes, a good education system and a good  health system – but also can we talk about Cuban medical internationalism that provides medical assistance  to countries in need? Somebody asked me was I advocating the  Cuban model because I thought it was good for everyone to be equally poor.  I must say I never even had a glimpse of poverty in the way I have seen it in many countries in Asia, Africa and other parts of Latin America in Cuba.  And so yes, since it is unlikely that this planet will hold everyone being equally rich, I could live with the Cuban kind of poverty, if poverty it is.  

As  someone now working on women's human rights, I cannot condone Castro's human rights  abuses and his restrictions on press freedom etc. As one BBC commentator remarked, Castro's human rights abuses were nowhere  as severe as many of the other human rights abuses in Latin America (and  elsewhere, for that matter). Yet there is no justifiable explanation or excuse for  that.  In fact the situation of human rights in Cuba brings into focus the struggle within the human rights discourse - namely the indivisibility of  rights, and the usual primacy accorded to civil and political rights over economic, social and cultural rights.

When my friend Bamba and I visited Cuba about 15 years ago, Fidel was still in control – but we didn’t see that Cubans were starving or malnourished, miserable or sad, frightened or insecure.  At that time there was a dual economy, the peso economy for the Cubans and a  dollar economy for the tourists. We arrived from  London on an Air Cubana flight,  with a  weeks stay in a small resort in Guadelavaca (Varadero was the more popular resort)  and a final day in Havana before we were scheduled to return to London. All for 450 British pounds (airfare included).  

Guadalavaca is the red dot


After enjoying the warmth of the sea and some skinning dipping, some thambili (never once seen thambili outside Sri Lanka), some dancing and some rum, we decided to hire a car and venture outside the tourist enclave. Initially, we drove to a little town outside our resort hotel in Guadelevaca, and many of the peso shops looked pretty dismal – much like the Sri Lankan cooperatives in the 1970s, with goods placed in dusty polythene bags in glass cabins that looked like they  hadn’t been opened for years! But the market for vegetables and dry goods was vibrant, and the people were not dragging their feet, but going about their daily business with energy that belied any kind of undernourishment.  In fact, I think the Cuban diet of beans and rice, coupled with a heavy dose of physical labour, produced some of  the best male physiques I had seen.  Not once in the whole week did we come across anyone, man or woman, boy or girl, young or old, that looked weak or malnourished. 

Our second trip took us further away, across the island from Guadelavaca in the North to Santiago de Cuba in the South.  The wide roads built with Soviet assistance had little or no vehicular traffic thanks to the embargo – the country providing oil to Cuba was Venezuela. An occasional Cuban on a horse would sometimes pass us by.  At different points on the road Cubans would gather for the next vehicle that passed that would give them a lift.  We soon got used to the system, and would pick up and drop people on the way – eventually deciding (against a lot of protests) that our vehicle was for ‘mujeres solamente’.  The fact that Bamba and I had little or no Spanish didn’t seem to matter. With the use of our little phrase book, we were able to communicate with our passengers.  One woman insisted that we stop by her house and have something to drink.  She had modest but permanent housing, electricity and running water (about 95%  of the island is electrified) and the fruit smoothie she made for us in her blender had so much sugar (the produce of the area!) it almost made my teeth go blue! 

In Santiago de Cuba, we were staying at a casa particulares, the home of an older couple (whose son-in-law worked in the hotel in Guadalavaca)  and when we got there  I realized that I had left my handbag at the woman’s house.  We had no option but to make the 40minute drive back, this time with our host in the car to direct us.  The bag was where I left it, dollars and other stuff untouched.  The woman meanwhile had baked a cake for an old aunt whose birthday it was, and knowing that we would be back for the bag was relying on us to help her transport it to her aunt’s house not too far away.

The house we stayed in Santiago de Cuba was a beautiful hacienda that now belonged to the state (there was no private ownership, as I understood), even though it had been in the family of the couple who were running the casa paticulares (or bed and breakfast). He made silver jewellery which he sold to the state tourist shops, but was, I think, a retired engineer.    We would see many other beautiful haciendas in Havana – shared now by  several families, or turned into primary schools.

What I remember most about Santiago de Cuba was the music.  Everywhere.  It seemed like everyone was a musician of some sort.  The groups that entertained people at the restaurants didn’t look like they were doing a job -  they looked like they were enjoying jamming!  At one bar frequented by Cubans after work, when the musicians left their instruments and went  to get themselves a drink, members of the audience picked up where they left off.   The music was seamless and musicians and audience flowed into each other.  And the old people.  Secure in Cuba’s social security system that provided them with a roof over their heads, food and health care, they spent the days singing, dancing, and playing music. Digging deeper, there was some resentment.  Our host  told us  that ‘some people are more equal than others’ referring to the political elite, and I am sure there were frustrations at the minimal remuneration for public servants etc.  But there was also a lot of pride – a  young man acting as a tourist guide, told us proudly, that even though the Bacardi family took the brand with them when they  left Cuba (after Castro had confiscated their assets) the true ’bacardi’ was still Havana Club, because it still used the Cuban water that was part of the original recipe!

The tour  took us for a  day to Havana where we were allowed to wander the streets till we were to catch our flight.  The old haciendas now converted into shared housing or into public spaces sat alongside some modern businesses.  I seem to remember a Benetton,  but thankfully NO McDonalds!  No hassling either and no feeling of insecurity for women on their own.

My main recollection was wandering into a street side book stall with Bamba and I chattering  in Sinhalese, and the old guy running it, curious I guess about this unfamiliar language, asked us, in English, where we were from. We told him, and he explained that he knew one other Sri Lankan (whose name now  escapes me).  Apparently he had been the Chief Chemist in Che Guevara’s Ministry of Industry and had met the Sri Lankan, also a senior chemist, at a conference in Moscow. Now retired he was running the roadside book stall. My thought was about the dignity of  labour that allowed a Senior Chemist in Government to  do this work in his retirement, without loss of status.  His ambition now, he said,  was to see the Olympics in China.  I hope he did.

At the airport we were given the news that the Air Cubana flight to Gatwick was cancelled and that the airline would provide us accommodation at the Havana Hilton(which was Castro’s headquarters when he stormed Havana, but which had been turned back into a hotel, owned and run by the state) and we would be given seats on the flight the next day that was flying to Paris Orly airport.  Obviously there were too few British passengers to make the Gatwick flight  viable.  This did not make the Brits very happy.  They found it hard to deal with a disruption to their schedules!   But as we received the news in a music filled airport (yes, there were groups  making music there too!) Bamba and I were thrilled! - an extra  day in Havana and a bottle of Havana Club as a gift – it all just turned out to be a fitting end to one of the best holidays  I’ve had.

Rest in Peace, Fidel Castro.  We should have the courage to listen, learn and adapt your strategies, not call you names.  Davids are much needed; the world is still full of Goliaths that need slaying.





Saturday, 29 October 2016

The latest weapon in the fight against disease DOES surprise me

A post by Sue Desmond-Hellman, CEO at  the  Bill & Melinda Gates Foundation on LinkedIn that randomly found its way into  my inbox is titled "The latest weapon in the fight against disease might surprise you" - hence the title of this  blog.

Desmond-Hellman makes the case for data as a resource  for turning the tide on a number of conditions.  Nothing  surprising there.  But it seems having spent much of her life as a clinical scientist, white coated (I assume) in medical laboratories she has had an amazing light bulb moment and realised that "non-medical data " can be  used "to complement medical research and  transform the lives of entire populations".

And how did she come to this realisation? Because of, in her words, a "great example" that she got to  hear about in Cincinnati, Ohio in the good old USA.    What has happened there?   " By combining existing data  from a variety of  sources, a team from the Children's Hospital has linked poor housing conditions in a particular neighbourhood to high levels  of  chronic asthma among children"  WOW!  a revelation indeed! And why is it a mind boggling, new weapon?  because now, this simple co-relation between poor housing and chronic asthma has shown that "medical  therapies, such as a steroid inhaler or airway opener  muscle relaxant like albuterol are only providing short-term fixes". The real solution to "ensure that children are not constantly returning to hospital, ..lies in making sure  their homes are free from mould, water damage, cockroaches and other pests"   WOW! again.

When did the wisdom of preventive health care completely leave health  professionals, that it has to be brought in again as a new  invention of the 21st century?  Backed by a new concept no less,  of precision public health.

Desmond-Hellman also  talks about the use of technology such as GPS systems to map outbreaks of infectious diseases such as the Zika virus.  Here she is on better  ground, but her comparison of Zika control in Haiti with Zika control in Florida, only serves to illustrate a point that has as much to do with the type of resources  available  to health systems - the poverty of states as well as neighbourhoods  - as it does with technology.

A prayer for those  pushing 60 year and beyond, includes the line "free us of the notion that simply because we have lived a long time, we are wiser than  those  that  have not lived so long" .  I am afraid Sue Desmond-Hellman has not helped answer that prayer.