In the face of coronavirus, Cuba is proving to be thoroughly humane, in stark and vivid contrast to the stance taken by the impeached president in the White House. Coronavirus was late reaching Cuba, where it arrived with Italian tourists, but, soon after it did so, Cuba nevertheless gave safe haven to a British cruise ship which other countries (including the US) had refused permission to dock because it was carrying several confirmed cases and numerous other passengers showing symptoms. (Those who could travel were quickly flown home, the others being treated in Cuba.)
A few days later, a group of 37 Cuban doctors and 15 nurses arrived in Italy to lend support to the crisis of care, a moment caught in a strangely moving piece of video of the medics descending the aircraft steps and one by one elbow-touching the official who greets them. It almost looks like a scene from a sci-fi movie where social customs are subtly different; you start by smiling but then, as they also greet the camera with an elbow, a wave or just a look, it brings you back down to earth. (A single shot lasting a full two-and-a-half minutes, the effect is cumulative.)
Cuba has a history of humanitarian medicine that goes back to the beginning of the Revolution, which, as one of its primary aims, introduced universal free health care based in the community, and hugely expanded medical education and research. It has a very high life expectancy and very low infant mortality, as well as research centres and medical schools that provide training not only for Cubans but also doctors from countries of the global south. One result is that Cuba boasts an extraordinarily high number of doctors per capita: 8.2 doctors for every 1,000 people – well over three times the United States (2.6) almost five times as many as China (1.8), nearly twice as many as Italy (4.1). The figure in the UK is 2.8%, and we know that this isn’t enough.
What Cuba does with all those doctors is send some of them to work as volunteers in poor countries with a lack of medical care; they’ve been doing it for decades – a total of 400,000 medical professionals providing healthcare in some 164 countries over more than fifty years. Right now (according to Newsweek) Cuban doctors are working in 59 countries around the world, 37 of which have confirmed cases of COVID-19. There’s more. If a healthy population was one of Fidel Castro’s passions, his pet project was the creation in the 1980s of a high-tech biotechnology institute which began to develop new drugs.* According to a report in Peoples Dispatch, these include an interferon used in Cuba as a treatment for HIV-AIDS, Hepatitis B and C, Herpes zoster or Shingles, Dengue and different types of cancers, which could help save thousands of lives in the COVID-19 pandemic. The medication increases the natural production of interferon in the human body and strengthens patients’ immune system, and is thus effective in treating coronavirus. It is one of 30 drugs chosen by the Chinese National Health Commission to combat the respiratory disease, and has been produced in China since January.
Cuba has been doing all these things while suffering an economic blockade by the USA which helps account for shortages of food, fuel and other basic necessities, and has been repeatedly and almost unanimously condemned by the UN General Assembly. A big reason why Cuba’s economic development has been stunted. A shift in US policy had to wait till 2014 when President Obama began a process of rapprochement, only for his successor to reverse it and double down with new measures – from cutting off oil supplies to halting cruise ships and then curbing air travel. As part of this intensified attempt to strangle Cuba’s economy, the White House has also been attacking Cuba’s humanitarian medical assistance, accusing Havana of ‘exploiting’ the medics they send abroad. However, according to The Guardian, Cuban doctors working abroad earn more than they would practising in Cuba, and while some of the foreign missions are provided by Havana free of cost, other countries pay for them, bringing in $6.3bn (£4.8bn) annually, much of which is ploughed back into Cuba’s health and social services. (According to official figures this is an astonishing 60% of Cuba’s foreign income, although this doesn’t include remittences from abroad.) Yet Washington demands that its allies in the region cancel their health cooperation agreements with Cuba, leading to the expulsion of Cuban doctors, nurses and technicians from countries like Brazil, Colombia, Ecuador and Bolivia, where power is held by right-wing regimes closely aligned with the US.
In a particularly grotesque example of semantic abuse – or fake news – the U.S. State Department has been classifying Cuba’s overseas medical missions as ‘human trafficking’. In Brazil, when the far-right demagogue Jair Bolsonaro took office and expelled Cuban doctors, he claimed they weren’t there to heal the sick but ‘to create guerrilla cells and indoctrinate people.’ More recently he called the idea that coronavirus posed a serious threat to public health a ‘fantasy’. Now that reality has set in, says a report in The Jacobin, he’s asking Cuban doctors to come back.
In 2016, Hurricane Matthew killed dozens of Americans and hundreds of Haitians. Not a single Cuban died. This is because another initiative that goes back to the 60s, following the devastation and deaths caused by Hurricane Flora in 1963, has been the organisation of what The Jacobin calls a ‘comprehensive, all-hands-on-deck’ disaster-ready civil defence system. Coronavirus will not be so readily combatted, but again it looks like being much worse in the USA, where the White is lacking in political will and there is no socialised medicine – in what is supposedly the most advanced health care system in the world but from which millions are excluded – because it’s all private, profit-driven, fragmented and disjointed. And perhaps Cuba has one other advantage: a much higher sense of community solidarity, both organised and informal, which begins at neighbourhood level and is accustomed to coping with straightened circumstances, like the economic collapse of the 1990s. Unfortunately the consequences this time round are likely to be just as severe, if not more so.
The pandemic is global and fighting it needs a form and degree of global cooperation which, as nations close their borders and keep their own advice, is not forthcoming. The same is true of the subject of our film Cuba: Living Between Hurricanes – the ecological crisis of climate change. There is evidence from satellite data (reported by The Economist, March 28th 2020, p76-8) that as countries go into lockdown, travel is restricted and factories shut down, there is a marked fall in air pollution, in China, in Italy, in New York. Nothing demonstrates more clearly that it is human activity that has caused the climate emergency, which hasn’t gone away, and that while coronavirus does its worst, our common reconstructed future still depends on confronting it without delay. The Economist, however, is sceptical: an optimist, it says, might see the fall in air pollution as a silver lining to what is an extremely dark cloud, but that would depend on it ‘being sustained when things return to normal… Unfortunately, not only is that unlikely to happen, but the response to the crisis could easily make things worse.’
Now we learn that COP26 the UN climate change conference due to take place in Glasgow in November, is being postponed; the venue has now been earmarked for an emergency hospital. Five years after the Paris agreement, this was supposed to be a chance to galvanise action for tougher targets. De Pfeffel in his election victory speech promised ‘to make this country the cleanest, greenest on earth, with the most far-reaching environmental programme’. He then sacked the woman who had been appointed to run it, Claire O’Neill (on the grounds that she was no longer an MP and the job should be held by a government minister) and gave it to Rishi Sunak, and then, when Sunak became Chancellor of the Exchequer, to Alok Sharma, the energy minister, whose response to the delay is a bland ‘We will continue to work tirelessly with our partners etc.’ But this we know: even if agreement at COP26 was always going to be a huge challenge, further delay in tackling climate change will make things worse. Whereas what we need is nothing short of a global green new deal, and now is the moment to go for it.
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* I had the fortune in 1987 to visit the biotechnology institute, soon after it was opened, while we were filming Cuba from Inside for Channel 4. Not to film there but because I’d heard about it and expressed an interest. Back then I understood nothing about the science, but the very impressive building struck me as a wonderful set for a sci-fi film (or perhaps a Cuban version of Alphaville).
A few days later, I saw another side of the health system. My mother had Parkinson’s and I’d also heard that Cuba had introduced a new treatment for Parkinson’s, involving a brain implant, also being used in Sweden, if I remember rightly. I expressed curiosity and was invited to meet the doctor in charge. This time I was already better informed and got very clear answers to my questions, and then the doctor plied me questions about my mother’s condition. What surprised me was when the fellow finally said he was sorry, but she was too old to be treated, but if she weren’t, he be delighted to accept her as a patient!