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Shortage of medications reaches critical point in Cuba

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HAVANA – It was just after New Year and I was walking down a broad avenue, observing and taking photos, when a man dressed in a house painter’s uniform approached me.

This happens in Havana all the time. Tourists stick out, and Cubans want to talk and say hello. Sometimes, rarely, they want something, a handout, or even a date. Ricardo was different. He was desperate, almost frantic.

He was clutching a small box containing an inhaler for people with breathing issues.

“Please mister,” he said in reasonable English. “I need $5. I have to go to the pharmacy and get a new inhaler for my daughter,” he said, showing me the used item.

Usually, I try to slough off such appeals. On a previous day a man started talking to me, gave me two cigars, then asked for $2 so he could buy something at the cafeteria nearby. I returned his cigars and walked away.

But I could feel Ricardo’s despair. He spoke as a father protecting a vulnerable daughter. Then he asked me to help him get to Canada so he could work and support his family. He said he earns $15 a month.

“But you pay no rent,” I replied, playing the devil’s advocate. “You get a ration of rice, beans, and small amount of animal protein, and have free health care and education.”

“Yes,” he countered, “but I still have to pay for electricity, phone, water, and medication,” (affordable and cheap – when the locally manufactured is available).

His daughter, seven, was born with a type of asthma apparently passed on from her mother, and the child cannot breathe without it. I gave him the $5. Ricardo posed for pictures with the old medication in hand, then insisted I quote him: “I am not a Communist. I am not a socialist.”

Of course, as someone who supported the Castro revolution of 1958, and the many positive changes that have occurred in Cuban society since then, this anecdote is not meant to diminish Cuba’s achievements. Among them are universal access to quality health care and education, and a culture of asking citizens to contribute to the best of their ability, sharing, wealth distribution based on providing essential needs, and pride in a vibrant culture and resisting American domination.

Cuban communism is hardly perfect, and as Fidel Castro has conceded, there have been errors. The U.S. economic boycott, repeated attempts by the U.S. and its Cuban exile surrogates to invade, attack, and sabotage Cuban facilities, the collapse in 1989 of Cuba’s main benefactor, the Soviet Union, have ushered in harder times, which persist. Much of the remaining ideological zeal is being devoured by a widespread desire for an easier life beyond subsistence-plus.

This impression is based on conversations with friends of long standing, and the fact that thousands of Cubans in the key 19-49 age bracket are moving to capitalist countries where they believe they will live better and freer lives, with more food on the table and better prospects for their children.

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Propelled by overall dissatisfaction, change is happening in Cuba, slowly, but while small shops now proliferate throughout Havana and travel restrictions have been eased, people in their most productive years are voting with their feet.

Also, in the aftermath of Fidel Castro’s death, Cubans are speaking out with greater frankness, as Ricardo was doing, across the street from the former apartment building that now houses Cuba’s Interior Ministry, which tracks dissidents.

It turns out that Ricardo’s problem is not an anomaly.

After inquiries with knowledgeable Cubans in the healthcare sector, and a friend who monitors the media for an important client, it all goes back to what he calls “a bureaucratic error” in 2014, which resulted in Cuba failing to pay suppliers in India and China for raw materials used to manufacture medications in Cuba.

As a result of serious arrears that persisted in the past two years, these suppliers have suspended shipments and this has affected some 160 medications, according to well-informed friends in healthcare. This means that Cubans such as Ricardo, who barely have enough money to meet essential needs, have to purchase much more expensive imported medication, which often is beyond their means.

One doctor, who gave me the figure of 160 medications, said that colleagues are scrambling to suggest combinations of available medication to make up for the unavailable products, which affect people with diabetes and other chronic conditions. According to this physician, these solutions often are “hit and miss.”

According to my observer friend, the situation is “almost critical” and Cubans who have taken for granted a high performing and quality medical treatment, including affordable medication, are extremely upset.

“The lack of medication, based on a shortage of cash and failure to pay suppliers, could continue throughout 2017,” my friend suggested.

It stems from the fact that Cuba’s economy, even with a robust tourist sector, is in trouble. In his year-end review, as reported by AFP, President Raùl Castro declared the Cuban economy had contracted by 0.9 per cent – the first time since 1995 that Cuba has reported negative growth. This compares to what Castro said was 4.4 per cent growth in 2015.

“If not solved this year, the country could face economic collapse,” my friend warned.

Much will depend on a hoped-for boost in tourism, based on a continuing flow of visitors from the U.S., who arrived in huge numbers over the Christmas/New Year break, and a hoped-for hike in crude oil prices, which would allow Cuba to resell oil at a favourable price from the still-friendly Maduro government of Venezuela, which allows Cuba to resell some of it at a profit.

Venezuela – Cuba’s closest ally – last year cut oil shipments to Cuba by 40 per cent and is roiling from massive inflation and economic and social crisis, tied to declining oil revenues. The supply of oil to Cuba is linked to its sending teachers, doctors, and other professionals to work there.

Cuba’s dependence on Venezuela recalls its similar reliance on Soviet economic support, which led to a reported decline of up to 15 percent in the Cuban economy in the early 1990s following the collapse in 1989 of the Soviet Union.

In the current economic climate and the uncertainty generated by the hard-line policies and “America-first” priorities of U.S. President Trump, it remains to be seen whether economic prospects for most Cubans will improve in the short term.

irblock@hotmail.com

2 Comments

  1. Maggie Bugden says:

    Wonderful to know. Too bad for those Cubans re “shortage of medicine”.

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