And I heard hope in the voices of the Cubans

IN THIS SERIES: Moon Over Havana, Returning to Cuba: Educational exchange promises new ways to think about mental health interventions

Malecon from Hotel Nacional’s garden

While Cuba is still a socialist country, it was clear on my February 2017 trip that much has changed and the people have high hopes for more opportunities since the United States lifted its trade embargo.

Cuba’s relationship with the United States has been intertwined for a long time, dating back to 17th century, starting the time of slave trading and sugar plantations, and into the 20th century. In the early 1900s, for instance, American troops built the Malecon, a broad esplanade that stretches along the coast of Havana, when Cuba was under American military occupation. The purpose was to create more hygienic conditions as yellow fever as an ongoing problem for Havana. And then in the 1950s, the American mob sought to create a Monte Carlo in the 1950s in the Caribbean.

By then, the Cuban people long had wanted their freedom from those wanting to run their country, which led to the rise of  Fidel Castro in 1959.

Jose Marti was a poet and a politician in the early 1900s who fostered the desire for freedom. He is now considered a hero in Cuba.

But now, in 2017, Cubans remain friendly to Americans and hope to continue to have fewer restrictions for trade after Obama’s March 2016 visit.  

Our guide for the educational trip offered this historical perspective to us during the week, as well as the most recent history during the 58 years of the U.S. embargo, during which Cuba faced many challenges – challenges we heard little about in America because of the embargo. After 1959, Cuba had to look elsewhere to purchase goods it had once easily obtained from the U.S., so it turned to the Soviet Union. Until the Soviet Union collapsed in 1991, it was Cuba’s main support.

The nine years that came after are referred to as a ‘periodo especial‘ because it was a very difficult time for all Cubans. Cubans sought ways to be more self-reliant, investing more in agriculture and creating their own biomedical industry, including herbs.

While my perspective is limited, I do want to share my observations of how life has changed for the Cuban people since my first trip in 2013. The marketplace is certainly more open. I did see Japanese cars on the street where in the past, few, if any new vehicles, were on the road. Even the tour bus we rode in was new in contrast to the last time. The Cubans mentioned that with the new level of tourism that is available, sometimes they are challenged to have enough food and water for the locals in Havana, but this is less an issue in the countryside. “Life is much easier for those living in the country these days,” was an observation Cuban colleague Fernando Maresma offered after he returned from visiting family in Cuba in January 2017.

It was clear socialism still shapes the society, but the new openness in commerce lent an air of hope. Many echoed the prevailing belief that Cuban president Raul Castro is more a pragmatist than his brother, the late longtime dictator Fidel Castro ever was. In fact, many perceive the openness has its origin in the time when Fidel became too ill to lead the country. That was 2013, when Raul was named his successor. It is with Raul’s efforts that the borders are more open for the local Cubans to come and go from their country.

Yet, the financial capacity to travel or purchase goods remains a challenge for many Cubans. Most cannot earn money beyond what the government offers. In Cuba, housing and medical expenses are free. Free food vouchers are available from the government and given to each Cuban. When money is earned outside of the monthly government salary, Cubans achieve this economic structure with a 70/30 split. This means that for every dollar earned, 70 percent goes to the government, 30 percent to the person.  

Wage limitations affect those who have graduate degrees in Cuba. Physicians make about $67/month, increased in the recent years from about $35. There are ways to earn more via the length of service and holding an administrative position in the hospital or medical school. Some add to their income by being taxi drivers. Additionally, medical doctors are viewed as a commodity for export by the government. For example, Venezuela has Cuban physicians offering primary care in exchange for oil to Cuba.

Cubans and Americans remain intertwined and have a mutual curiosity. Limitations imposed by governments abroad and locally impact Cubans greatly. And yet, I find an incredible resilience and willingness to work and find ways to serve and support each other and their community. There appears to be a sense of hope with recent changes though many Cubans shared their concern about the changes in our current American administration.

NEXT IN THIS SERIES: How traditional/holistic medicine is interweaved with allopathic medicine in Cuba.


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