Leaving Cuba is a frequent topic of discussion and frustration. Cubans have it the worst, and their plight is well documented. Those of us with residence here, foreign workers and students, must be granted visas to leave. However, the involvement of the Cuban Government does not end there. For those of us who are students at the Latin American School of Medicine (ELAM) we must complete an obligatory week of quarantine upon return to Cuba.
Quarantine is not unique to Cuba. Mandatory quarantine has been documented for thousands of years before the word medicine even came close to taking on its modern significance. Leprosy is a classic example, with plenty of examples in any of the texts of the three largest monotheistic religions. I first read about Cuban quarantine in Tracy Kidder’s popular account of the life and struggles of friend of Cuba and world doctor Paul Farmer in Mountains Beyond Mountains.
Kidder describes the quarantine of HIV positive Cubans, especially soldiers returning from the freedom struggles in Africa. My strong notions of individual liberty were challenged greatly by the fact that this obligatory quarantine was probably the most significant factor in keeping Cuba’s HIV rate much lower than its Caribbean neighbors.
Quarantine at ELAM is usually in a dormitory on the campus or at a facility about 20 km away. The conditions in quarantine are not so much different from those outside. Someone who didn’t know better couldn’t tell a group of quarantined students from students in the general population. The food is the same, the beds are the same; we have plenty of time to study. But the fact remains: it is obligatory and we cannot leave before a doctor declares us safe to enter the population.
So both times I have traveled abroad and returned to Cuba I have known what I must do upon return. I try to face my week of quarantine with an attitude that my being apart from everyone else will protect the health of my hosts and fellow students. If I am lucky this attitude can help me make it through the first twelve hours without starting to think how badly I want out.
The desire to escape is mostly part of a strong mammalian instinct that tells us we should not want to stay somewhere we are not allowed to leave. To illustrate this example find a cat that has been sleeping in the same spot for the past few hours. Now put your hand on the cat and hold it in this same place. The cat will squirm out of your grip and scamper away.
In quarantine the students invent all sorts of ways to get out. They destroy property by breaking metal storm shutters and crawl out. Some students sneak out past sleeping guards at night. Others make deals with doctors or instructors to shorten their days or keep them off the quarantine list. A few just never report and hope their presence is overlooked.
The human mind is in no short supply of ways to get out of compulsory separation from the rest of our species.
So while some people complain about their problems in securing their right to travel, others complain about their forced quarantine when they return. Either way, it is the Cuban Government with the first, and last, word on our trips abroad.