Impressions of Cuba
Health care is a model, but tourist economy brings
changes.
By
Russell Mokhiber
and
Robert Weissman
Our first, short visit to Cuba has left us impressed with the
accomplishments of the island-nation that for more than 40 years has stood
up to global capitalism. We also returned home aware of the many limits of
the revolution – some brought on or exacerbated by U.S. economic and
military pressure – and uneasy about the difficulties Cuba faces in the
coming years.
Walking into Havana's
Jose
Marti Airport, we immediately sensed that
this was not like other places: there was no raft of billboards urging us
to drink Coke, smoke Luckies, charge with our MasterCard, or rent a Hertz.
Indeed, there are virtually no commercial advertisements in Cuba. (Nor, by
the way, is there a personality cult surrounding Fidel Castro: we saw far,
far fewer images of Castro than we would, say, of President Daniel Moi in
Kenya. The omnipresent image in Cuba is national hero Jose Marti, the poet
and writer who helped lead the Cuban revolution of the 1890s.)
We saw a country with
major accomplishments in health care, education, day care, and other
services. Cuba'a infant-mortality and life-expectancy rates are comparable
to those of the United States and other rich countries, and the country's
main health problems are now those of rich countries. "We die as wealthy
people, even though we live as poor people," one hospital director told
us.
Cuba has invested in
and maintains a sophisticated hospital system, with hospitals spread
throughout the country, not just concentrated in Havana. Even more
important is the national emphasis on preventive health measures and
primary and community care. Every person has access to a community doctor
and nurse, who serve several hundred neighborhood families and know the
health profile of all their patients. The women's association and other
mass organizations, which are organized down to the block level, also help
ensure care is delivered – for example, making sure every pregnant woman
receives prenatal care. Cuba has also invested heavily in biomedical
research, giving it one of the only genuine biomedical R&D capacities in
the developing world.
We were also taken
with the economic egalitarianism of the society. Following the collapse of
the Soviet Union, Cuba lost more than a third of its national income in a
single year. If the United States were to suffer anything remotely
similar, there is little doubt that the heaviest burdens would be thrust
on working people and the poor. In Cuba, the pain has been spread equally:
people have maintained their right to health care and education and
housing, and they were allotted food rations that gave them a minimum
level of sustenance. Even in times of genuine food shortages, no one, so
far as we know, starved.
The country's former
economic dependence on the Soviet Union was, as it it should now be
obvious even to those who might once have argued otherwise, one of the
great mistakes of the revolution. Of course, this was a dependence foisted
on Cuba in no small part by the United States through its embargo and
continuous military threat.
Relatedly, Cuba erred
in relying on agricultural exports (sugar above all) produced on vast
state-owned plantations, instead of cultivating food for domestic
consumption on smaller, farmer-owned cooperatives. Over the last decade,
the country has made considerable strides in remedying this mistake, with
more autonomy granted to farmers and a new emphasis on organic agriculture
(Cuba is now a world leader in the field). Food, however, still seems in
short supply.
One of the biggest
threats to Cuba's accomplishments on the horizon is posed by the tourism
industry and the dollar economy. Cuba's greatest potential
foreign-exchange earner, by far, is tourism. Tourism is certain to grow
rapidly, spectacularly so if the U.S. embargo is ever lifted.
Salaries in the peso
economy are on the order of $20 to $30 a month. With subsidized or free
housing, utilities, food, health care, and education, this is enough, or
at least close to enough, to get by. Workers in the tourism sector are
tipped in dollars. A maid or waiter will easily make far more than $30 a
month in tips. And so the incentive is for doctors, nurses, teachers, and
others to leave their jobs and go work in the tourist sector. The result
is both a misallocation of professional and skilled labor and the
beginning of social stratification. There is no obvious solution to this
problem that maintains the fundamental achievements of the revolution.
The problem is
exacerbated by remittances from Cuban-Americans living in Miami and the
gifts of toys, designer clothing, and other items that they provide to
family in Cuba. Walking by the hip clubs in Havana's Vedado neighborhood,
one can feel the magnetic pull of the corporate culture on kids who have
little way of understanding the very dramatic sacrifices their society
would have to make were Versace and Nike goods to become freely available.
Posted by Bulatlat
Russell Mokhiber
is editor of the Washington, D.C.-based Corporate Crime Reporter. Robert
Weissman is editor of the Washington, D.C.-based
Multinational Monitor.
They are coauthors of
Corporate Predators: The Hunt for
MegaProfits and the Attack on Democracy (Common Courage
Press, 1999). Focus on the Corporation appears Tuesdays.
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