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Archive for February, 2012

Disobedience

Observing daily life in Cuba is becoming increasingly misleading. Under the supposed calm of a society where nothing seems to happen, the forces of different and often conflicting trends are moving. And these movements could potentially generate conflicts of different types and magnitudes. A brief and no doubt incomplete analysis reveals an undeniable reality: nothing is immutable, nothing is eternal, not even — who would have believed it — the totalitarian regime camouflaged under the generic euphemism of “revolution.”

In recent weeks the unwillingness of the government to search for political solutions has become clear. The misguided declaration of the General-President telling us that no one should “have illusions” with regards to eventual political changes was terse, but it has the advantage of eliminating the prolonged wait for some negotiation with the regime. Then, a negotiated solution with the miniscule power group excludes possible scenarios, precisely because the will of that group.

That is, the dictatorship has clearly exposed its reluctance, not only toward changes and inclusions, but even the pretense of a fictitious social pact. To put it briefly and bluntly, the gerontocracy and the acolytes of the generalship have barricaded themselves in their trenches. And that’s from a positive point of view, thus simplifying the march and justifying the search for alternative solutions in pursuit of democracy. Unwittingly, they have passed us the baton.

At the same time, the picture is getting bleaker. Economic figures show an unstoppable increase in the cost of living, rampant impoverishment of large sectors of society, the inefficiency and inadequacy of government measures aimed at the so-called “renewal” of a model that remains on life support — that is, because of the existence of an also precarious Hugo Chavez in Venezuela — and the inability to overcome the crisis under current political conditions.

Socially, the soaring delinquency and crime rate, the deterioration of the systems of health and education — practically on the verge of collapse — widespread discontent, frustration, lack of prospects, despair, the decapitalization of confidence in the system and  despondency, are all components that could lead, in the relatively short term, to a crisis of governance, the implementation of large-scale repression, or a combination of both.

On the other hand, never has there been a larger sector of dissatisfied protesters and the public will to exercise rights. The political challenge is manifested, beyond ideological tendencies, in resistance and the growth of larger and larger groups of independent civil society; in the rebellious attitude of new and old generations of dissidents; and in the speed with which these groups have been consolidating and linking to each other, despite the repression and surveillance of the servants of the regime.

The strength of these independent groups lies mainly in their open and inclusive character and their stepping back from ideology, which makes them immune to penetration by agents of the regime. At the same time, access to new technologies has been a catalyst to allow the diffusion of ideas in a medium that is beyond the absolute control of the government, despite the low connectivity of Cubans to the Internet.

The weakness of the regime lies in exactly the opposite characteristics: its closed and unchanging character, its secret and conspiratorial nature, its exclusions, its urgent need to control information and to hinder the free flow of ideas and opinions, and its need to appeal to repression as a desperate measure to slow its own inevitable end. An untenable position in the midst of a world ever more globalized and plural.

The Cuba of today has the same government it had 53 years ago; however, is quite different from that of just five years ago. And this is not a conceptual blunder. Five years ago we were not even aware of the existence of so many outraged among us; we had not thoroughly understood that we are heirs to over half a century of repressed dissent and that it’s not required to fight guerrillas in a fratricidal struggle: it is enough just to disobey.

Now Cubans increasingly understand that our bad leaders are there because we have allowed them to be, that political capital belongs to citizens, not governments, that a regime cannot sustain itself, and that the hope for our future lies precisely in the fact that this government has no future. As the civil resistance begins to move beyond its survival phase, the government adopts strategies to survive. The roles are changing imperceptibly. Now the most imminent danger is the expected response from the government. An escalation of repression from the base to try to prevent the dissidence from gaining strength.

Today, the political apathy of a large mass of the population might seem an obstacle to achieving democracy. However, this apathy is also the prelude to the denial of support for the regime: something like the wisps of an old myth that has died. The revolution ended decades ago, Cuban socialism has never existed, false social achievements did not survive the spurious grants from foreign governments, and the corrupt regime has no moral capital to demand greater sacrifices. Without its permission and without its liking transformations have been building steadily from within the island, and the regime’s stubbornness only tends to accelerate its end: Cuba is changing and the future no longer depends on them, but on all of us.

(Article originally published in Diario de Cuba on Monday, 13 February 2012)

February 17 2012

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Following the publication of the post “The Broken Showcase” in this blog, in which I noted several criticisms of the Cuban health system and the loss of professional ethics by not a few doctors, a reader was kind enough to send me the letter of a doctor with the surnames  Alemán Matías, which circulated on the web, not in response to my post but in response to a note which was published some time ago in the Letters section, a feature that appears every Friday in the Granma newspaper.

However, as somehow the topic is related, and as I have opposing views to those wielded by the aforementioned doctor, today I propose to my readers to comment on the letter, transcribed in full below, and whose writing, spelling and style I have respected without altering them in the slightest. I do not cite the web source because I’m transcribing directly from the message of my reader. I urge readers, in order to avoid misunderstandings, to bear in mind that Dr. Alemán refers to a letter published in Granma and not to my post of last Monday, February 6:

And the patience of the doctors?!

On Friday, November 4, 2011 was published another letter of the many that have already been published, constantly criticizing the medical staff that still has the dignity of working in the National Health System. The letter in this case, entitled “Patience of patients,” doesn’t speak about the myriad difficulties faced daily by health workers, but superficially criticized and, in a way that has become a tradition, in a non-constructive way.

In other words, the doctor has no right to speak, amid all her difficulties must remain stoic, and can not comment to her partner over a breakfast she can’t eat that morning because if she did she would miss the bus and not arrive early to attend to the patient who would later feel every right to criticize her, and so this is one of what are countless examples of what doctors could talk about that would not fit in all the pages of a newspaper.

That doctor has to have all the patience to sit and wait for a bus, to arrive at the school of her child where they tell her there is no teacher or they do not have lunch, to arrive to buy detergent for the month in CUC, a currency in which she does not receive her wages, and to wait for the clerk to finish gossiping with the one next to her, to deign to check out everything she would buy.

Patience to come and pick up the garbage cans, overflowing outside her home and on every corner, the community workers, who surely have the right and time to have pleasant conversations so that they forget they have to clean up the city trash.

I speak as a doctor, because it is because of this that I arrive at ten o’clock in the morning in the operating room without having been able to have breakfast and having to tell my co-worker next to me how hungry I am! And knowing that there is no snack and that lunch will arrive at 2:00 pm and at that hour I will be able to have lunch although it will be a taste of what they give the doctors and the rest of the workers in this section.

But the physician continues standing there, giving the best care to the patient she is operating on, and who will later have “every right to criticize all doctors” who although conversing, gave him quality medical care, which all Cuban doctors continue doing, and all which all the people of Cuba should be proud of, yet they continue to judge us without having the least idea of the inhuman conditions in which we work and how much we contribute to society.

I will end with the same question: Should we get used to this?

Dra. A. Alemán Matías

Specialist 1st grade of Anesthesiology and Reanimation.

So much for the letter-catharsis of the doctor. Now, from my personal perspective it is obvious that the evil is deeper than many thought. For starters, it would seem that Dr. Alemán understands that doctors are some particular kind of breed to be placed above the rest of humanity. That is, the vast majority of Cubans of any profession, occupation or trade pass through identical material deprivation and problems, they have to wait for the bus for long hours, often have nothing to eat breakfast, are paid in local currency and need products that are sold only in hard currency and, to round it off, they get sick. Therein lies our greatest disadvantage.

I believe that every patient is within his rights to demand better treatment and better care from the doctors, regardless of whether or not they have eaten, particularly because the patients are not responsible for the material privations and the personal problems of the physicians. Health is the most precious of treasures, which explains the concern and anxiety of the patients when they are forced to go to consultations from which they often emerge without a diagnosis, in hospitals where frequently the necessary equipment to perform complete exams doesn’t exist, or where there are no reagents for the lab tests. We have experienced going to the labs where, in addition, “they don’t have” intravenous needles, which rapidly appear when we open our wallets. It’s an irrefutable reality that happens with such regularity it’s become a tradition. Not to mention the shortage of medicines.

If the patient requires hospitalization, then his concern and that of his family members increases exponentially. You are almost always admitted using your own resources, your own bedding and personal effects in every detail, generally you must bring your medications from home and your family must guarantee your food to avoid your consuming the gastronomic offal that is hospital food. The conditions of the rooms and bathrooms are another chapter of horror: lack of water, blocked drains, cockroaches, filth, are a constant in most hospitals. And I am referring only to the hospitals in the capital, with two or three honorable and rare exceptions. I urge Dr. Alemán to disprove something of what I’ve asserted here.

Another feature of the Cuban health system is the absolute impunity with regard to medical patients. Cubans do not have the slightest opportunity to challenge a diagnosis or to sue doctors and hospitals for mismanagement or fatal errors. The examples of silencing them abound. About two years ago a cousin of mine died in the Naval Hospital in East Havana. Unknowingly she had an ectopic pregnancy and in the face of severe abdominal pain that came on suddenly she was rushed into surgery. From there, shortly afterwards, she emerged dead. She was 40, a healthy and beautiful wife, mother of two children, and in the matter of a few hours she was dead. It was the consequences of the effect of the anesthesia, whether this was fatal or there were other complications we will never know. She, Ana Margarita Celaya, was cremated, a family left devastated, but the doctors of that unfortunate surgical intervention continued practicing. At best, what happened that day, is that they had not eaten breakfast, go figure.

My father was diagnosed with a metastatic brain tumor just five days before his death, although for more than six months we had been frequenting consultations and specialists in various branches of medicine. The scanner could not detect his illness and only the MRI, that my older brother and I managed to “resolve” — that is, arrange for — through some friends, discovered too late his impending death. Up to that moment we were wandering around hospitals, trying to figure out what strange illness was making my father lose his balance, be so confused, forget even my phone number, become more and more melancholy, suffer sleep disorders and lose control of his legs and even speech. The doctors said it was “stress,” that he had “anxiety,” and prescribed one psychotropic after another for months. Perhaps knowing earlier what he was suffering from would not have changed the outcome, but at least he would have had a better quality of life in his last months. I will never forgive the health care system — the political system, a source of many evils — for my father’s terrible agony.

For me, personally, on January 28 they diagnosed me at Calixto Garcia hospital with a kidney infection I never had. They did no analysis of any kind and prescribed me oral antibiotics. I, who was vomiting, almost dehydrated. Of course, it was my fault for coming to a consultation without “sponsors,” knowing as I do what the system is.

Dr. Alemán should convince Yoani Sanchez of the ethics of the doctor who attended her after she experienced the beating given to her in a closed car by various minions of the political police. I saw the bruises from the blows and helped my friend through her painful convalescence. The doctor, who initially recognized the marks of the blows and the bruises on Yoani’s body, soon retracted under pressure from the agents of the repressive forces. A monument to Cuban medical ethics, I think.

If I were to list here all the personal anecdotes of my friends and acquaintances in their experiences as Cuban patients, I couldn’t do it in a single blog nor in my entire lifetime. So I cannot accept that a doctor feels particularly offended by the criticisms leveled against the Cuban public health system and some doctors. It’s very bold of her to speak on behalf of all doctors when she says that patients are given “quality medical care, which all the Cuban doctors still offer.” Not true. I know that there are still doctors who provide excellent treatment to their patients with a professional zeal that is increasingly deficient in half of them, but far from “all.” Recently I heard of a doctor of Centro Habana who does not even take the blood pressure of pregnant women in his consultation “because he has to attend to many” and ultimately they even stopped paying him the 25 CUC a month that he received for having completed an international “mission.” If that is ethical I prefer to “die in my own bed” before going to a doc like that.

For the rest, I suggest to Dr. Alemán that she properly focus her anger. The best would be that she complain to her superiors about the bad working conditions, the low salary, and the dreadful food offered her during her workday. That she protest and focus her outrage upward, not downward. The patients shouldn’t have to resolve her problems, much less suffer the consequences. In any case, all doctors who ever decided to study for such a humane career and to take their Hippocratic oath, know what the Cuban conditions are. It doesn’t seem to disgust many of them to go and sacrifice themselves in Haiti or in the most remote village of some obscure country, amid the filth and disease at the risk of losing their own health, to be able to acquire household appliances, other trashy little things and a little more money. With all due respect, I am not convinced that they do if from a stroke of pure altruism. When a doctor is mobilized to some remote destination outside of Cuba, he doesn’t say, “No, I mustn’t abandon the patients of my clinic.” But if they send him to some lost village in Las Tunas or the Sierra Maestra, he howls to the heavens. And it’s that in Cuba spiritual values have deteriorated almost irreparably, faced with the material miseries of life.

No, we Cubans really don’t have much reason to feel the pride the doctor asks of us. Much less the appreciation. Instead, we feel helpless, abused and often humiliated. We feel powerless because we have no choice other than to seek the services of doctors of dubious quality. To go to a clinic at random in Cuba has now become a kind of Russian roulette: only if you’re lucky do you save yourself. I don’t play.

February 13 2012

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On the Same Side

Palace of the Revolution. Photo taken from the Internet

These days of rest, when I have not even had the nerve to open my machine and write, have instead been used to think about the Cuban reality, present, future and my own assumptions. Friends and enemies have branded me as inflexible on more than one occasion, or at least as excessively caustic. And they’re right. Not in terms of my usual bitterness about the government: I reiterate every invective and criticism I have dedicated to the autocracy, and multiply my bitterness towards it exponentially. I do not like it, do not approve of it at all, and will fight against it in my surly style as long as I am alive; I have a deep contempt for this and other dictatorships, and I refuse to serve or obey the regime.

But I’ve also been a bit unfair in my judgmental ratings towards my countrymen, especially when I attack what I consider to be the people’s excessive passivity and docility. Permanent helplessness has a dulling effect on the senses that prevents any clearly formulated proposal. In conversations with some friends that I’ve been nursing these days, I have been pleased to see that people are neither so weak nor so blind; they just have not found the way. Many are not permissive, but fearful. The characteristics of dictatorships are magnified in the people’s imagination; they look larger and more powerful than they really are. Now that image is beginning to crack.

One example is a friend of mine, who, without my suspecting it, is a regular reader of blogs on the Voces Cubanas platform. I did not even realize that, for years, she has known what I do, and is a regular fan who urges her son, — a twenty-something young man — to put everything in digital form that is published in the independent web, including sites of Estado de SATS and recordings of Razones Ciudadanas, among others. For my part, I had not spoken to her about my political views or of my dissident activities, though my opinions are well known and are even shared among all my friends. I do not like to scare people, but the opposite effect was evident in her: “since I’ve read your posts, since I found out all about and what you do, I’m less afraid. Each time I’m more convinced that the only way to fight this government is to stop playing its game. I want my children to know something besides this, a Cuba different from ours”.

So, I made a mistake too. I have underestimated the power of freely expressed opinions, I have underrated the scope –- limited, yet inexorable — of the independent press and the individual will of the disobedient, and I have overestimated the fear of Cubans. This friend is a member of the Communist Party, one additional faker, but she has also been, for a long time, a silent activist who has taken to her workplace, her friends and family nucleus, recorded on disks and flash drives, the whole spectrum of opinions currently stirring in Cuba, especially anti-government views.

Additionally, I have recently become convinced of the power of believing in our own strength. We, the disobedient, are not an “underground” phenomenon.  We walk with our heads held high, and make public our meetings, aspirations and opinions. The government is the one underground, locked away in its palaces, plotting its own conferences and laws. Hidden are the power lords, fearful that people might find out what they are scheming, terrified in the presence of the effects of whatever measure they might propose, disconcerted at the slightest possibility that Cubans might have access to information. It is true that people are afraid, but the masses are generally more ignorant than cowardly. The ruling Cubans are actually the real pack of cowards who hide behind the force that gives them absolute power to suppress and prevail. However, they survive in a permanent state of shock, mistrusting even their own followers. Therefore, I ask Cubans, at least those whom I misjudged, to forgive me. You are in hiding, we are in the open, but, at the end of the day, we are all on the same side.

Translated by Norma Whiting

February 10 2012

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Broken Showcase

Façade of the Emergency Center at Calixto Garcia Hospital. Photo taken from the Internet.

Anyone who still harbors any hope about the niceties of the health system in Cuba has only to get sick and go see a doctor. It’s not hard at all, taking into consideration the number of rare diseases circulating among us these days, just within reach. And there are other illnesses, already endemic, such as dengue fever, that are here to stay and thrive in our environment, reinforced year after year by the arrival of returning missionaries, laden with new diseases to share, and those students benefitting from the rapidly dwindling ALBA programs, who are still bringing us new strains of diseases that are becoming endemic on the Island.

In recent days I was one of the “lucky” ones to receive the collateral benefit of the Castro comradeship. I acquired — I don’t know how or where — a strange virus that caused me three days of high fever and a total of 10 days of nausea and vomiting. My stomach barely tolerated a bit of water and some cold juices, and just three or four days ago I resumed my normal eating habits. Of course, my healthy constitution, my size and my good diet allowed me to firmly support the onslaught and survive the experience with sufficient strength: I scarcely lost a few pounds. Others have not been that lucky. I inquired among friends and acquaintances and learned that there are dozens of people who have been admitted for dehydration and were given IV’s. No one has obtained an accurate diagnosis for this disease and everyone is exposed to contract it, since no one knows for sure how it spreads. In the consulting rooms, doctors look at you with almost commiseration and pronounce the ever-cryptic same old sentence: “it’s a virus”.

I suppose that studying and practicing medicine in Cuba has become a game both mystical and very simple at the same time: everything that is not dengue, is “a virus”, and everything, including dengue fever, is treated in the same way: plenty of fluids and rest. So here we are.

In any case, a quick visit to the Calixto García Emergency Teaching Hospital finally convinced me that the dazzling showcase of public health, a bastion of the regime’s propaganda, is definitely broken. The building, recently repaired, has the same chaotic look as everything in the country: patients lying on stretchers in the middle of the waiting room for everyone to see, empty consulting rooms, doctors with expressions of bewildered astonishment and confusion, talking among themselves as if patients were merely  basic means and unfortunate diagnoses, such as what I got, when the little doctor who barely looked at me ventured to pronounce a diagnosis without labs or any other additional tests: kidney infection. I don’t have to tell you that I did not follow his indications for antibiotics, and I ended up where I should have started, asking my doctor friend to accompany me to which she kindly agreed, to order blood tests so dengue fever infections could be ruled out and conclude with the same enigmatic little word “virus”.

“Stay home. Don’t go to hospitals unless absolutely necessary. Thank God you’re strong and you’re getting better. No one knows what and how many diseases we now have, and for seven months there is a dengue epidemic that hasn’t been declared nor will it ever be declared. The health system has collapsed, medical ethics is in the process of extinction, and the only hope is that all this too shall pass. Stay home, friend, and may God protect us so we can see how this will all end, because what we need to do, is survive it.”

My friend is a very wise doctor.

February 6 2012

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Santana Cartoon illustrating the post in Penúltimos Days

A European friend who recently visited Havana asked me what my greatest wish for this year 2012 was. Of course, she expected me to express to her the same old litany: the end of the dictatorship, democracy, peace, freedom, etc. The wishes that tens of thousands of Cubans have made each New Year’s and that, despite all the sorrows, have yet to come true. Maybe the propitiatory spirits, those that presumably participate or influence human aspirations need to perceive something more than the resolve in those who make the wishes… a signal indicating a little more vigor to make dreams achievable, something that can fulfill that old saying: “Help yourself, and God will help you.”

So I simply said to my friend that, for 2012, I wish to see Cuba full of angry people, for it is on that day that we will be closer to such longed for rights and democracy. I’m not referring to childish protests of indignation on any corner or line, in different tones of voice and willing to be silent when some guy who looks like a political cop stares us down; for State transportation problems, or for the increasing reduction of so-called “subsidies” the national method, distributor of the parameters of poverty. Neither do I speak of the more or less biased comments about “how bad this is getting”. For at least 20 years I have been listening to the phrase “what’s so good about this is how bad it’s getting”, or “never is the night as dark as before dawn”, and in all that time, there hasn’t been the slightest improvement or light. What’s more, everything around us is sure to be getting worse and darker, so it is obvious that a change is needed, but not on the part of an autocracy that clings to power and naturally resists change. What is needed is a change of attitude among Cubans.

My greatest desire for this 2012 is, therefore, that ordinary Cubans, those who in all the speeches are grouped under the generic term “the people” decide, once and for all, to make their outrage public and evident. We could, for example, protest in the streets, or in front of government headquarters, to demand an end to the dual currency, since wages are paid in one currency and most products are marketed in another. By the way, it would also be relevant to demand that wages dignify the job, be a source of well-being and not the object of a joke printed on paper money. We could demand the repeal of the retrograde exit permits and all limits on emigration that keep us prisoners, slaves of the Island-plantation. We could reclaim the sacred right to information, the right for the flow of ideas, to participate in making decisions about our destiny, to choose what kind of education we give our children. We could make demands, in short, about how and by whom we wish our country to be governed.

If you think that such claims exceed the heights of indignation of some, perhaps we could start by protesting the unstoppable rise of food prices, or stand up to the abuse of most public officials, or publicly denounce corruption, which ends up striking the needy the hardest. We could just ask to have the CDR’s disbanded, (those that are still members of the CDR’s [cederistas]) or stop attending accountability meetings and the utmost caricature of democracy: the constituency “elections”. Because — beyond the protests taking place in the First World which the official media have the nerve to disclose here — and if there is one thing we don’t have a shortage of in Cuba it’s a reason to be outraged.

So I modified my wishes for this year, believing that, for democracy to finally emerge, we Cubans need to stop looking outward and upward, waiting for solutions from the solidarity of others, from the Cuban government, or from God, and assume our share, through responsibility and law. Recent statements by the President-General — on the occasion of his counterpart’s farewell, the Iranian dictator visiting Cuba, to our shame — that the Communist Party’s National Conference, to be held on January 28th, will be just the organizing of the inner life of that (political?) organization, presumably to comply with the guidelines of the past VI Congress, lends the coup de grace to the aspirations of large sectors that still had moderate expectations for a public debate about the decisions of the government, including some Catholic Church sites that have been voicing for an “inclusive and transparent” dialogue between the government and the Cuban people. It will be interesting, given the circumstances, to follow those sites’ editorials to find out what new proposal they make us.

So, what I want for 2012 is this: indignant people. Thousands and thousands of Cubans angry about over half a century’s worth of fraud, outraged, if only to salvage the spoils of our national shame that still remain after decades of dictatorship.

—–
Work originally published in Penúltimos Days (http://www.penultimosdias.com) on January 13rd, 2012

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