Cuba: Reporting in Times of Cholera

Fernando Ravsberg*

HAVANA TIMES — Very soon we’ll have to read the Cuban press using technical dictionaries to allow us to understand what they’re talking about. Now, for example, they are telling us that something called Vibrio cholerae has been detected in the city of Manzanillo.

It seems they avoided telling us about cholera to spare us the worry. In that same sense, we were calmed by the assurance that the three Cubans who died with this diagnosis were old people who were also suffering from other diseases.

According to my colleagues at Ediciones Martes, “Fortunately the Cuban health system has nothing to do with journalism.” They claim that the doctors are better organized, have a plan of action and the system is run by people who “graduated in medicine.”

Undoubtedly the media can look enviously at the professionalism of the public health care system in Cuba, with its preventive nature, its long-term strategies, its capacity for rapid response and the respect that society has for its physicians.

But now the Ministry of Health has new challenges, such as protecting people from diseases that Cuban aid workers might bring back with them from abroad, exercising control over the tens  of thousands of self-employed workers who sell food, and monitoring the joint venture foreign companies operating on the island.

Large companies such as the Havana Water Department (Aguas de La Habana) must be required to carry out their roles. That company spends part of its budget on the purification of water in the network while there are thousands of leaks and pollution sources that lead to the loss of half of the city’s “potable” water.

The presence of Cuban medical teams in Haiti fighting cholera is laudable, but the truth is that this involves exposing thousands of doctors to the disease, which means that controls or quarantines should be in place upon their return to prevent the “pollination” of the disease.

The twofold risk of Vibrio cholerae: From abroad and at home

Cuba has thousands of aid workers serving in Africa in many sectors, from health care to construction, and any of those individuals might return with cholera or other harmful microorganisms.

Given the amount of money these professionals produce for the country, a hotel could even be devoted to them, one which would combine the necessary quarantines with their well-deserved rest. This would probably cost less than a health campaign such as the one in Manzanillo.

But the problems are not only coming from abroad. During the macro-crisis and the mini-opening of the economy in the 1990s, I did a report on “El Manguito,” a town in Matanzas Province in which a private fried-food vendor killed dozens of people.

The man was carrying around malanga…or corn (I don’t remember which) in a bag contaminated with insecticide. With this he made the dough, fried it and sold his treats.

He ended up in jail but suffered a much harsher punishment, since one of the dead was his daughter.

I don’t mean to imply that the danger comes only from self-employed workers, because I know that terrible things happen everywhere. But the truth is that in the state sector there are certain rules and practices that reduce health risks.

A food specialist explained to me that while health standards are also violated in state-run enterprises, the difference is that it’s easier to “trace” the problem to ascertain its origin, place and the moment of contamination.

With over 400,000 self-employed workers in the streets — most of them devoted to food service — it is imperative to put effective disease control mechanisms in place that serve to protect the consumer, certifying that they can eat and drink without endangering their health.

But it won’t be enough to deploy legions of inspectors. The key is to open wholesale outlets that can compete with the prices on the black market. When a self-employed worker buys their products in these, they will have greatly reduced the health dangers presented to the public.

This is just one example of how the internal tug-of-war could impede the internal development of the master plan of reforms, creating a deformed model with dangerous black holes, the result of negotiations in which each law is accompanied by a “but.”

The authorities authorize the sale of cars, “but” only used ones; they distribute land, “but” farmers are prohibited from building homes on those parcels; and they allow self-employment, “but” fail to provide wholesale outlets that sell those workers the essential supplies.
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(*) An authorized Havana Times translation of the original published by BBC Mundo.