Caregivers in Cuba Require Autonomy and Wellbeing

if they are going to provide care to others

An elderly couple in a dance therapy session outside the Belem Convent Day Care Center, in Old Havana. Studies insist that services and support systems are inadequate for families to provide care, especially for the elderly. Picture: Jorge Luis Baños / IPS

By Luis Brizuela (IPS)

HAVANA TIMES – Idalia Martinez believes effective strategies are needed to support the caregiving tasks middle-aged women in Cuba like herself normally take on, which place barriers on her professional performance, autonomy, and wellbeing, she recognizes.

Such a strategy is even more pressing in a context of accelerated population ageing, growing migration levels of young Cubans and a more severe economic crisis on this Caribbean island that casts obstacles on caregivers to provide food, find medicines and manage resources.

“My 92-year-old mother has a hip replacement, because she broke her hip five years ago. I have to make sure she doesn’t slip, bathe her, give her medicine and help her out with some activities,” 57-year-old Martinez says, who lives in the Marianao municipality, one of Havana’s 15 municipalities.

I also help out with my only granddaughter, because my daughter needs to catch a ride very early in the morning to get to work. Looking after the four-year-old girl means waking her up, giving her breakfast, taking her to preschool. I pick her up in the afternoon, give her a bath, feed her something, and also play or read to her, until her mother arrives,” she added.

In a conversation with IPS, Martinez agreed that “being a web editor and working from home [helps her do these tasks], but I really need to manage my time and work in the night and early morning lots of the time,” which doesn’t give her time to rest.

“Caring for loved ones has also made me aware of who I am, what I deserve in life, how I can do things better, how I can help other caregivers in a more difficult situation than mine, and to be aware in the family environment and stand up for our rights”: Idalia Martinez

“My social life has dwindled a lot. I have to turn to other people for help when I go to buy food or try and sort out other formalities, which here almost always means lines and quite a bit of time. A neighbor helps me out and talks to and watches my mother while I’m out,” she pointed out.

While she gets support at times from a sister and her niece, “they live a good distance away. When they come, we take turns, but my sister is much older than I am and also has ailments that require attention.”

Martinez said that caregiving “really restricts her ability to catch up with friends, go to the theater or movies, especially the International Festival of New Latin American Cinema, which I really enjoyed,” every December in Havana.

She called life as a caregiver “hard”, because “it’s work that isn’t paid and doesn’t have any visibility in society either. You need the support of an entire family, to agree on things, because while I am responsible for looking after a person, I also have my own needs.”

According to Ramirez, while she has barely any time for self-care, “I try to keep my fingernails and toenails clean and neat, even if I can’t always paint them. My daughter takes care of this on the weekend. I’ve let my white hair flourish, I don’t dye it anymore, although a hairdresser near my house treats my hair. This is also a short window for me to talk and socialize.”

She added that she also tries to “read or watch a movie I’m interested in,” in the evening.

An elderly woman takes part in a handicrafts workshop at the Belem Convent’s Daycare Center, where the elderly are given specialized care. Experts recommend that a comprehensive care system needs to be established in Cuba, and that the number of old people’s homes and institutions to support families needs to increase. Picture: Jorge Luis Baños / IPS


The National Survey on Gender Equality, carried out in 2016, revealed that Cuban women dedicate an average of 14 hours more than their male counterparts to unpaid work, which includes looking after the elderly, the chronically ill and dependents, as well as helping out with children’s and teenagers’ homework.

Meanwhile, the 2017 National Survey on Population Ageing, the results of which came to light in 2020, revealed that approximately 68% of people providing help are women and most of these women are 50+.

In the case of needing care, over 57% of the population over the age of 50 would prefer care to be given by a woman, according to the study.

Studies point out that caregivers normally find their life projects stunted, which leads to inequalities in access to opportunities and further reinforces gender inequalities.

Other analyses agree on the fact that this overload of domestic work, help with the family and care for dependent persons, as well as the devaluation and invisibility of these tasks, might be considered a form of the patriarchal system’s violence against women.

The sexual division in labor has ingrained the idea that after their labor as workers outside of the home, women are “obliged” to take on a second working day in their homes.

Redistributing and appreciating this work would improve Cuban women’s real chances at personal and professional development, autonomy, and wellbeing.

There are other challenges linked to the domestic economic crisis that make aspects of everyday life more precarious and as a result, makes people who receive care, as well as their caregivers, a lot more vulnerable.

In addition to problems getting enough quality food at an affordable price, in a country with significant inflation and insufficient agricultural production, “it’s extremely hard to find medicines or supplies such as disposable diapers, cotton, alcohol or even detergent to wash sheets regularly,” Mauro Sanchez points out.

This retired 67-year-old veterinarian, living in the Central Havana municipality, told IPS that she’s been looking after her father, who is 89 years old and suffers from dementia, for almost a decade.

This “means really being there for him. It’s very demanding and it exhausts you. Without family support or donations, it’s very hard to look after a person properly with this condition.”

She admitted that even though her two brothers give money and some products, “I take on the brunt of the care. As there aren’t very many medicines at the drugstore, I must buy some that he needs for high blood pressure, diabetes, or to keep him sedated, on the street (illicit market), they’re really expensive. Neither my father’s or my own pension is enough.”

“I believe we’d really benefit if there were mechanisms that would make it easier to buy certain supplies, as well as food. This would better organize and improve our time, so we can focus more on the person we are taking care of,” Sanchez pointed out.

Two elderly women talk in areas of the Belem Convent’s Day Center, where the elderly are given specialized care. The National Survey on Population Ageing (ENEP), carried out in 2017 and published in 2020, revealed that approximately 68% of people providing help are women and most of these women are 50+. Photo: Jorge Luis Baños / IPS

More support for families and caregivers

Approximately 221,000 elderly people live alone in Cuba, most of whom are women, whose life expectancy is above 80 years old, compared to 75 years for men.

Out of this group, the average being 71 years old, over 82% only have income coming from their jobs or pensions, while almost 8% have special needs that require help from another person or constant care, ENEP confirmed.

Figures from the state’s Cuban Office of Statistics and Information (ONEI), reveal that 22.3% of the Cuban population is 60 years old or over, and by the end of 2023 this percentage would have gone up by 1%.

By 2025, one of out every four inhabitants on the island will be an elderly person. A decade later, this population group will account for a third of the total and will increase pressure on the economically active population, which will shrink at the same time.

Since 2016, when the population reached a maximum of 11.2 million inhabitants, the Cuban population has begun an abnormal downswing, with different factors coming into play such as the exodus of younger generations, a sustained decline of the global fertility rate and a higher number of deaths compared to the total number of births per year.

By 2025, Cuba will have less than 11 million citizens; 17 years later, this will drop to 10 million and there will be less than 9 million in 2055, according to ONEI’s calculations.

Economic conditions on the island are encouraging emigration right now, especially of professionals and people mostly between 15-49 years old.

Caregiving is mostly falling on the shoulders of 50-something-year-olds in Cuba, with the consequent physical and psychological exhaustion this entails, which also puts them in a vulnerable situation.

Studies insist that despite the Cuban Government’s efforts, services and support systems are inadequate for families to provide care, especially for the elderly.

A comprehensive caregiving system is recommended, which would increase the number of old people’s homes, prioritize training more nursing staff, doctors and assistants specialized in geriatrics to face challenges posed by dementia and disabilities, as well as health and psychological care to improve caregivers’ quality of life.

They also advocate for promoting studies about support systems for caregiving, which take into account personal details, social conditions and services to provide care, and also to take care of their own health and wellbeing.

Ramirez said that the creation of WhatsApp groups “of people who look after loved ones has allowed us to share experiences, notify each other if some products appear and to buy or share certain supplies.”

Looking after her mother and grandmother, the web editor admitted “caring for loved ones has also made me aware of who I am, what I deserve in life, how I can do things better, how I can help other caregivers in a more difficult situation than mine, and to be aware in the family environment and stand up for our rights.”

Read more from Cuba here on Havana Times.