Sleeping on the Havana Malecon
Alfredo Fernandez
Her house shoes are under the bed close by her feet, so if she has to go to the bathroom during the night she won’t have to step on the cold floor, since that’s bad for her health. The “bed,” though a bit hard, is at least a “bed.”
Unfortunately this picture is absolutely real. For her bedroom, this woman uses the Malecon sea wall that segregates Havana from the rest of the planet. This is the same site that was initially created for get-togethers between friends or so that lovers could sit and watch the sunset.
Along with fishermen looking for cheaper sources of proteins than are sold in “dollar stores” for hard currency, today the Malecon includes a woman, an insanely sick person, who usually sleeps here. This woman, abandoned by a society that has situated her to the margin of a decent life, despite her illness, today must subsist under precariousness conditions.
Adding to the difficulties suffered by mentally ill people who live in this society — which is a challenge even for the more rational people who live in Cuba— the misunderstanding and mistreatment to which they are subjected by some leaves the street as their sole option for a home in more than a few cases.
Although to tell the truth, if I lost my mind tomorrow, no matter how bad things got I’d also prefer to live in the street, strolling around everywhere with my home on my back. Because who would be so crazy as to risk being admitted into a Cuban psychiatric institution, where the deaths of scores of patients during one cold night have still not been explained by the flagship hospital in that specialty.
The city of Havana has granted this woman the use of this bed that’s “a little bit hard” since the city lacks appropriate care in shelters that we’ve heard promised to the point of exhaustion by the gods, who today one would have to be mad to believe in.
I have also been in the psychiatric hostital in La Havana, and I had the chance to see and talk to many of the interns and doctors. There was a time where patients were tied to the bed, sexual abuses were quite frequent and if I don’t remeber wrongly, there was more than one death due to doctors beating interns and such things. Everyone accepted that, including doctors. But so it has happen in all other developed countries during the XX century.
Now it has nothing to do with that old model. Patients have music groups (I specially remember one man playing music with a set of spoons, what an amazing ability!!), get art lessons and tenths of other activities which contrivute to their recovery. Now, I don’t know how a psychiatric hospital in a first world country is. But I think the care they give in that hospital has nothing to envy to that of any other center.
Alfredo Fernandez, what is your point? If it is to say that this one sad woman and her homelessness is proof along with the deaths at the Psychiatric Hospital in Havana that Cuban mental health services and the socialist effort are imperfect, you need not be so dramatic. I know of no one who claims any country’s system is perfect, and most mental health and social service workers will readily admit that most are cruelly and needlessly inadequate. But if your point is that Cuba is among the worst, your evidence is specious.
I am a social worker in Maryland and Washington D.C. with 30 years of experience. I have visited the psychiatric hospital in Havana and some other mental health and medical facilities in and around the city. What I saw and spent a few years studying showed that if we use anecdotes and personal observations, Havana is light years ahead of Washington D.C. Now keep in mind that D.C. is the capital and nerve center of a hugely rich country. Further, besides the significant numbers of powerful and wealthy people, there is a large African-American population with disease rates equal to the worst of Africa. Official figures. Take a moment and compare HIV/AIDS rates and treatments in DC with Havana.
Recently, D.C. shut down all its remaining mental health centers. The services and numbers of homeless and chronically mentally ill they served were a fraction of what was needed 30 years ago and were reduced now to zero. Instead, the remaining “hard core” mentally ill totally dependent on meager services for survival, were farmed out to charitable organizations. Cuba with a tiny fraction of the monies available to D.C. is clearly doing much better – even with the tragic examples you cite.
So, if your point is to somehow help this woman and all others who need safe and quality services in Havana, then say so and maybe suggest how that might be done. When and if I talk to any mental health workers again in Cuba, I will raise these issues, but I will also ask them what they are doing and suggest could be done to make the outcome better. I would finally never suggest they copy the U.S. models of punitive health care. These problems are tragic and demand we all do better. Better is a mentally health concept whereas criticism that blames without understanding is a mentally and socially ill approach.
During the years I worked as weekend house manager at Morningside Emergency Shelter here in Brattleboro, Vermont (1985-88, and 1991-2006) there were many cases such as this. One I particularly remember was a young man who actually was working, but couldn’t afford to rent a place. Before he found a place at our homeless shelter he lived in a crypt at the local cemetary! Others lived in tents out in the woods–even in the winter, when it can get down to minus twenty or minus thirty degrees celsius. One man had been in the major leagues (and it was true, since he showed me his newspaper clippings), but now was on the streets. Another had been the manager of a big box store, but when his company–Ames–was driven out of business by Wal-Mart he lost his job and, since he was in his late 50’s, was never able to find another one. He lost his house, his marriage, and finally wound up at our shelter. Somehow, he reminded me of Willy Loman in Arthur Miller’s “Death of a Salesman.” Finally, I just couldn’t take it any more. When I first began the job, in 1985, I thought homelessness was just a temporary problem; as the years passed, however, I saw it becoming more-and-more a permanent condition in our society. Also, I was becoming too cynical, too burned out, and always expecting the worse of humans; hence, after finding another position, I resigned, to allow someone with a more positive outlook to take over.
In Cuba the goverment help those people but is the family the one ho has to pay attention to them. Hospitals or doctors can´t do nothing if the family don´t ask for help. You better find more information before writing those things. You can find other people on a wall not only in Cuba, but also in that SO GREAT country you got.