Cuba: 20 Years of Services for People in Crisis

HAVANA TIMES — The year was 1995. The Cuban economy was in shambles, and so were people. Suicide figures skyrocketed, until we were seeing more than 2 thousand cases every year and the phenomenon became a statistically significant cause of death. Though these figures decreased slightly later on, treating people in crises is still a priority.

“We do not conceive of these individuals as people with mental disorders. We are simply dealing with individuals who face a problem at a given time and need to confront it with the help of a specialist. The people who visit us most are average Cubans. People don’t feel stigmatized here. Our work consists in restoring their emotional and spiritual health. We do not prescribe medication.”

That is how Master in Psychology Myriam Alvarez describes the program Telefono Amigo (“Friendly Phone”), after joining the initiative twenty years after its creation. Speaking of the program’s origins, Reverend Hector Mendez, from the First Reformed Presbyterian Church of Cuba (located on Salud Street, Centro Habana), says:

“We knew of other projects, including those that the YMCA commonly supports. Our project was different in that it didn’t use volunteers. In Cuba, we needed recognized professionals. This doesn’t change the fact that they do not receive payments for the services they offer, however.”

Telefono Amigo is a non-profit initiative. Members do not accept gifts or any other privilege (something which has become common in Cuba where medical services are involved). This peculiar manner of offering health services became highly popular very quickly. Pastor Mendez expands on this:

“We started offering services over the phone, but we soon found it necessary to open a consultation. The only advertisement we had were the people who used our services.”

As the project originated within a Christian church, one cannot help wonder whether it has any sectarian or religious content. The Presbyterian reverend immediately dispels our doubts:

“It is not sectarian. No one is asked about their religious beliefs, political affiliations or sexual preferences. What we do is offer people a warm welcome, quiet and inner peace, as well as total confidentiality, guaranteed by a document that the patient and doctor sign and the environment we provide as such.”

A woman who came out of the clinic agreed to share her opinions with us, while putting away a thermos in her purse:

“As you can see, this is different than seeing a doctor at a hospital. No one comes asking for favors here. You don’t come to ask them to sign prescriptions or documents vouched by a doctor in exchange for anything. They wouldn’t even accept a coffee from me.”

After devoting 15 years of her life to this social experiment, Dr. Myriam acknowledges she has acquired vital knowledge, a new contribution to what she learned at university:

“Before, I conceived of human beings as a bio-psycho-social complex, a soviet concept. Here, I learned that there is something more, people’s spirituality and souls, their individual mystique, their deep beliefs and experiences, which are difficult to share with their peers. It’s not just a question of faith or religion, but what people believe in their daily lives.”

Our interviewee shares an interesting concept, that of recognition:

“It is a question of recognizing what human experience is, the relationship between the psychologist and the patient. They do not confront one another, they get to know each other, they communicate face to face. A person with professional experience tries to help another.”

Cuba’s health services are presented as an example of the superiority of socialism at home and abroad. It would be reasonable to expect that an independent project of this nature be considered a challenge to this and that its development meet with obstacles. Pastor Mendez explains that:

“It was never our intention to compete. There are no contradictions with public health. There is no profit, no proselytism, just pastoral advice. We maintain good relations with the Faculty of Psychology at the University of Havana, the Center for Psychological and Social Research at the Academy of Sciences and the John Paul II Center for Bioethics.”

Dr. Myriam Alvarez adds:

“I speak of my experience at scientific fora organized by those institutions. They have even recognized the contributions made by our program and we have already been accepted as pioneers in what are known as “help lines” in the country.”

Three professionals (all women) take turns in phone or face to face consultations. A retired geriatrician, Dr. Humberto Santander, shares his interest in natural medicine and his singular understanding of the elderly, who account for the greatest number of people facing personal crises.

Of the nearly 10 thousand patients, 70% are women and more than half are elderly. Why the predominance of females?

“Women are better equipped for identifying health issues and face less social prejudices when they seek help. Let us not forget they often shoulder heavier burdens every day: their work, their homes, their husbands and kids and sometimes the additional strain of having to look for extra income or advance professionally.”

Given the extensive experience of the psychologist, we asked about suicide. There are more than a hundred cases on paper, even though it is difficult to quantify this phenomenon, given the inexact criteria used to diagnose traumas.

“When we treat people with very negative states of mind or major depressions, they are usually referred to a psychiatric service. The most important thing is that they came, that they placed their trust in us. That is how one starts on the road to improvement.”

Telefono Amigo can be reached every day at 866-8410. The church also offers its services at the church located at 222 Salud, in the afternoon. The church building is a rather atypical edifice inspired by traditional Anglo-Saxon architecture, with pointed, red-tiled roofs and walls decorated with beautiful glass works.

Before we say goodbye, I ask about that initial, bold move in 1995. Pastor Hector Mendez and psychologist Myriam Alvarez respond:

“We set limits on ourselves many a time, but, when things are done with transparency, honesty, responsibility and love, there is no reason to worry. What we offer is love, born out of our Christian faith. This is not a means of making a living, it is missionary work. There are no goals, no figures to reach.”
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Vicente Morin Aguado: [email protected]