Chikungunya Virus Spreading Nationwide in Cuba
After hurricane Melissa eastern Cuba is highly vulnerable
HAVANA TIMES -On Monday, November 3, Cuba’s Ministry of Public Health (MINSAP) announced during a press conference that, up to that date, 20,062 patients had been diagnosed with chikungunya in hospitals and clinics across the country. Another 2,000 cases had been classified as “suspected dengue.”
The prevalence of both diseases was concentrated mainly in the western and central provinces—particularly Havana, Matanzas, Cienfuegos, and Camagüey—according to Dr. Carilda Peña, Deputy Minister of MINSAP, who spoke at the briefing.
The supposed precision of the official statistics surprised the few Cubans who—despite Hurricane Melissa and widespread power outages—managed to watch the reports broadcast by the state-accredited press in Havana. For most people, the numbers presented by the authorities were far below the real magnitude of the epidemic.
“At least on my block, nobody’s gone to the doctor. Why bother, if even the children are sent home with nothing but instructions to rest and stay hydrated? I’m sure that, for statistical purposes, we appear as a ‘healthy’ neighborhood, even though right now there’s at least one sick person in every household,” said Mirna Betancourt, a resident of the Camagüey city of Florida. In 2019 and 2021, that municipality became the epicenter of two waves of contagion that arrived from the western provinces, first dengue, and later COVID-19. On both occasions, health authorities downplayed the severity of the crisis, to the point that several officials ended up facing trial for negligence.
At first glance, the situation now seems less serious. Most people with chikungunya are being cared for by their own families, relying on home remedies and whatever nutrition they can manage to improve. And little more. Lacking prior experience, Cubans have had to learn about chikungunya as they go. Digital pages and social media accounts have proliferated, sharing practical advice on how to deal with the illness.
Cuba is experiencing an exponential rise in infections, “mainly because the virus had never circulated in our country with the current intensity. That means population immunity levels are low, which becomes a decisive factor,” explained Dr. Maria Guadalupe Guzman, Director of Research, Diagnostics, and Reference at the Pedro Kourí Institute, during the Monday, November 3 press conference. “We are aware there’s an undercount of cases, which is why self-care measures are essential,” she acknowledged.
All Eyes on the Staircases
At the end of October, the first secretary of the Communist Party in Camagüey Province, Jorge Enrique Sutil Sarabia, toured several municipalities to “check on the measures being taken to confront the epidemiological situation.”
Along with Florida and the provincial capital, the industrial city of Nuevitas figured prominently on his itinerary, due to its economic importance and difficult environmental conditions. In early October, trucks and other equipment from the Ministry of Construction had to be mobilized to remove dozens of garbage dumps that had spread throughout the city, fostering a rise in dengue cases. But like all emergency campaigns, that effort lasted only a few days—after which the garbage, and its resulting contagions, quickly returned.
The crisis stems above all from a shortage of public sanitation workers. Low wages and lack of tools are among the main reasons that have decimated the ranks of street sweepers and the so-called “campaign operators,” the MINSAP employees responsible for locating and eliminating mosquito breeding sites—such as those of the Aedes aegypti, transmitter of both dengue and chikungunya.
Any realistic analysis of the situation would have to begin by acknowledging that solutions to the crisis depend on a government response. For instance, without a pay raise for sanitation workers, it’s unrealistic to expect more people to take up that tough job. And without more cleaning crews, garbage dumps will continue to proliferate—along with the vectors and the epidemics.
However, in a surprising rhetorical move, Sutil Sarabia chose to overlook the overflowing dumps, overgrown lots, and leaking water mains, and instead focused his criticism on the cleanliness of apartment staircases, where much of the population of Nuevitas lives. “Almost all of them are filthy, and that’s the residents’ own responsibility. That’s where community hygiene begins. We can’t forget that most mosquito breeding sites are still being found inside households,” he declared.
Blaming the public is hardly unusual in Cuba. About a month ago, officials in Santiago de Cuba blamed residents for storing water improperly. Lacking proper containers, many families resorted to using old bathtubs and uncovered tanks—a questionable practice, to be sure, since it fosters mosquito breeding. But in doing so, officials glossed over the fact that large portions of the city had gone months without a steady water supply.
According to provincial officials from the National Institute of Hydraulic Resources (INRH), when Hurricane Melissa struck, most neighborhoods in Santiago were receiving water only once every 40 days. “When you have to store water for a month or more, there’s no choice but to keep it however you can,” one Santiago resident commented on the INRH’s Facebook page.
The East at Risk
Santiago de Cuba has become a pressure point for the government amid the ongoing post-hurricane recovery. On top of the damage caused by Melissa’s wind and rain, the city faces a long-standing water crisis and serious sanitation problems tied to garbage accumulation and vector proliferation. In fact, the so-called “Heroic City,” together with Havana, Villa Clara, and Camagüey, accounts for two-thirds of all mosquito breeding sites detected in the country.
What’s most worrying is that, unlike the western and central cities, the eastern capital has yet to experience chikungunya outbreaks on a large scale. But the virus looms as a major threat to Santiago and, more broadly, to all the eastern provinces. The environmental conditions are ripe for the devastation of the hurricane to be compounded by a disease that has barely begun to be studied in Cuba.
With that in mind, activists in several provinces have begun gathering medicines to send to Santiago de Cuba, Granma, and other devastated areas—especially to residents of the Cauto Valley, who have returned to homes flooded with mud. “Many people had to sleep on porches, or wherever it was dry. The smell is awful because of the number of dead animals and the lack of drinking water,” said one local resident in a video shared on Facebook.
None of the inhabitants of Río Cauto, Guamo, or other nearby communities seem to have time to think about the danger of chikungunya—like a shadow spreading from its original outbreak in a former sugar mill town in Matanzas. But not thinking about it doesn’t make them immune. As long as the debris and garbage pile up and fumigation remains a distant memory, the epidemic will continue to claim victims across the island—at a pace no MINSAP statistic will be able to capture.