Friday, March 27, 2009

Traveling in Cuba by Bus and Private Car

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We wanted to see the Cuban countryside, so we decided to take a bus from Havana to Cien Fuegos. We'd been strongly advised to buy our tickets in advance. As usual the bus station was in a little-frequented area of town, well away from the centre. But after about an hour’s walk we found it – a surprisingly modern cement and glass building, which even had a sign out front saying what it was.

Inside, on the left, were two glass-fronted wickets – one marked “Venta de Pasages” (tickets) and the other marked “Informacion.” As we wanted to travel the next day, I figured we could just buy the tickets: we didn't really need 'informacion.'

As usual, there was a queue. The guy ahead of me seemed to be buying tickets for an army. The officious fellow behind the counter handled the transaction painfully slowly. He wrote the date and time of the bus on each ticket, carefully forming each number, pausing to rest in between the filling out of each ticket. It was an arduous task. Once the writing was done, he searched below his counter and came up with an old wooden ruler which he used as a guide to help him each ticket neatly from its stub. One by one. It was an exhausting procedure.

Then it was my turn. In my best and most polite Spanish, I asked for two tickets on the bus to Cien Fuegos tomorrow. Wicket-man gave me a withering look: “You have to go to the other wicket – informacion – and make a reservation.”

Taken aback, I made the unforgivable mistake, in Cuba, of questioning an official: “do you mean I can’t buy a ticket?” His look went from withering to outright hostile: “I didn’t say you couldn’t buy a ticket. I said you have to make a reservation at the other wicket.”

The other wicket was just one step away, behind the same counter. The woman at this wicket was a little more pleasant, but equally officious. I asked for a reservation. “No problema,” she replied, reaching for a huge ledger book. I wrote our names out for her, and she copied them carefully, checking each letter as she wrote, into the big book. Then she told me to come back tomorrow, an hour before the bus, to buy the tickets. Not having learned my lesson, I asked “Can I buy the tickets now?” Her response was much more positive than her co-worker's – indifferent rather than hostile. “You can if you want to.”

With that she passed the heavy reservation book over the token divider that separated the two wickets to our officious friend. But by that time there was someone else there buying a ticket, so I had to wait again. Finally I bought the tickets, and witnessed again the tedious procedure of filling them out and tearing them from their stubs. Wicket-man ticked off our names in the book, and handed it back over the divide to the woman with a triumphant flourish. Now things had been done correctly.

The next morning we arrived an hour early and sat in a cavernous waiting room with a few Cubans and a number of foreign tourists. On one side of the room was a glass counter displaying approved tourist souvenirs – postcards and t-shirts of Che, a few boxes of cigars and a few bottles of rum. On the other side was a rack of books. Almost all of them were about Cuba. A few were picture books with wonderful photos. But most were political and historical treatises, all from a distinctly Cuban (paranoid and militant) perspective.

Like most tourist buses, and in stark contrast to the assorted wrecks used to transport Cubans, our bus was fairly new, with proper plush seats, curtains, air-conditioning, a sound system and a tv. Unfortunately the air-conditioning was either off or on high, so we were alternately sweltering or freezing throughout the long ride. The sound system or the tv were on the entire time, and always at full volume. Fortunately we had ear plugs.

As we left Havana, our bus kept switching from one side of the divided highway to the other, depending on which side had the fewest potholes and the most continuous pavement. The median over which we crossed was covered with de- rather than con- struction rubble. Throughout the entire trip we were seldom able to travel at a reasonable speed for any longer than a few minutes before the driver would slam on the brakes to creep over or through another pot-hole, another break in the pavement.

Fortunately we had a series of massive propaganda billboards to entertain us as we went. There was Fidel's bearded puss glaring defiantly: “socialismo o muerte!” (socialism or death). We often wondered if the 'or' ought not to read 'and'... . And there was George Bush, with the one word “terrorismo” written under his image. Cuban propaganda is anything but subtle. It hammers its point home, over and over again.

We stopped for a snack and a bathroom break in a fairly major town about half-way to our destination. The washrooms were the most disgusting I have ever come across, in any country in the world. The women’s toilets had no door on the outside, and no doors on the stalls. There were pieces of old plywood propped up in the openings where the doors should have been. None of the toilets had seats, and none flushed. The floor was awash in urine. The sinks were mostly broken, but it hardly mattered: there was no running water.

As we carried on through the Cuban countryside I found the experience more and more surreal. Here I was riding in a relatively luxurious bus watching an American war film while travelling through some of the poorest, most decomposed villages I have ever seen. Many of the houses and apartment buildings were in an advanced state of decay: crumbling foundations and walls, missing or broken windows and doors, exposed and broken water pipes and wiring, and the usual piles of litter and garbage everywhere. It was particularly heart-breaking to see the many ragged children playing amidst the garbage and decay. What kind of life was this?

When we reached our destination we were met by a Cuban friend who had arranged with another friend to pick us up and take us to the small town where they both lived, about 40 minutes’ drive away. Cubans are not permitted to give foreign tourists rides in their private cars. If they do, and they're caught, they may be fined, or have their car impounded on the spot. But there was no bus service to the town we were going to, and a taxi would have set us back almost $100. We'd agreed to pay our friends $50 – for them a bonanza that was worth the risk.

Right from the get-go our driver was very nervous. There were several policemen around the bus station. He suggested we meet him around the corner. We walked in opposite directions as he and his friend took our bags to the car and we walked around the corner. When he picked us up we saw he'd put all of our bags out of sight. They were stowed in the trunk. He asked us to get in the back seat, slouch down and hide our faces under our hats and scarves.

His paranoia was evident as he wove his way through the back-streets of the city, avoiding main thoroughfares where the police might be stationed. Once we were on the road out of town, he relaxed a bit. We passed through a couple of check-points, but they were unmanned, and we weren't stopped. But then we came to a road block, where two policemen were standing in the middle of the road. One of them held up his hand, motioning for us to stop. The driver stopped well back of the policemen. We could feel his anxiety.

He jumped quickly out of the car. We watched as he shuffled, head bowed, towards the policemen – a picture of humble subservience. We slouched further down in our seats, pretending to be asleep. Our other Cuban friend smiled and waved at the policemen. “This is what it's like in this country,” he said to us. “They have nothing better to do than harrass us, try to catch us. And then they just want money.” The policemen gazed in the direction of the car, but didn't come over to inspect it. Either our driver gave them a 'propina' (bribe), or they were just too lazy to bother.

Our driver came back and in a low stage-voice said: “I told them you were my parents, and that I'd just picked my mother up from the hospital. Keep your heads down.” The driver and our friend chatted animatedly, laughing and joking loudly as they passed by the policemen. Everyone smiled and waved. We slept through it all.

The rest of the drive, mostly in the country, was fairly relaxed, but as we neared our destination, the driver once again became more vigilant, scanning the streets and side-streets for police. We took one pass down the road that our casa particular (bed and breakfast) was on, but there were too many police there, so our driver said he'd stop around the corner: we could walk to the casa from there. He and our friend would bring our bags later.

It was all so cloak and dagger, so paranoid, and yet necessarily so. For us it’s impossible to imagine the fear that Cubans live with day by day by day. But this is the Castros' Cuba, where fear is a fact of life, and stealth and lying have become universal and accepted ways of coping.

Cuban Roads and Vehicles

To view more of Ruby's photos of Cuba go to:

Consistent with most of the island's infrastructure, Cuba's transportation system lurches between inadequate and non-existent. There have been few upgrades to roads or modes of transport in the years since the 1959 revolution, and almost none since 1990 when the Soviet Union collapsed and all aid to Cuba was suddenly and unceremoniously cut off.

Most of the island's roads are in poor to dreadful states of repair. Many are impassible in the wet season. Even the major highway into Havana is discontinuous and pot-holed. The sidewalks are in the same deplorable and dangerous condition – manholes with no covers, inexplicable gaps in the pavement, loose cobble stones, and litter and excrement of all kinds, including human, everywhere. The expression “watch your step” takes on a whole new meaning here.

Most Cubans either walk or ride bicycles. A few – especially in Havana – have motorbikes. In the cities, if they have longer distances to go, some Cubans may use bicycle or motorcycle rickshaws. Or catch a ride in a 'collectivo' – a wagon pulled by a horse or an old tractor – that follows a standard route, like a bus.

On one occasion we hired a horse and cart instead of a taxi – we thought it might be fun. But it was hard to enjoy the ride. The poor skinny sweating horse had to work hard: the wooden cart was heavy, and its wooden cart wheels made the going tougher. He was sweating profusely and foaming at the mouth by the time we reached our destination. He is given no food or water all day.

The drivers of these carts show no mercy or kindness to their horses. They keep nagging at them with their whips, jerking the reins about, and yelling at them to get up or move over. Although most of the ‘bridles’ mercifully have no bits, the nose bands are almost always just a length of uncovered chain. This bites into the soft tissue of the horse’s nose, causing lacerations that have no time to heal.

A few Cubans do have old cars – and Cuba is famous for its old cars. Most of them were purchased in the 1950's, before the revolution, and have been kept going with a little chewing gum and a lot of Cuban ingenuity.

It's not unusual to see an old Chev or Ford with a Russian diesel engine, with a Czechoslovakian fuel pump, Russian transmission system, Polish brake master cylinders, Toyota steering wheel – whatever they can find and cobble together. The only 'original' thing is the body.

It's also not unusual to see one sitting by the side of the road with it's hood open, a couple of guys fiddling with the engine. Or one in the middle of the road, with three or four guys pushing it in the hopes it may start.

There are a number of Russian Ladas, ugly boxy autos that are at least reliable – most of the time. They are almost uniformly white or black and battered. They're most frequently used as taxis, although in Havana there were a few newer Toyota taxis. Very few Cubans ride in these taxis – they're for the tourists.

By far the most colourful 'taxis' in Cuba were the 'coco-taxis' – little yellow coconut-shaped two-seater bubbles made of fibre-glass and powered by a motorcycle engine. They weren't comfortable or fast, and they certainly weren't safe, but they were fun. And we did see Cubans riding in them once in a while, presumably for a cheaper fare than we were able to negotiate.

When Cubans have to travel a little further than their feet, bicycle or a collectivo can take them – to another town or city – they may try hitching. As we travelled on the main roads between towns we would frequently see large groups or long lines of Cubans with their thumbs out. Some looked like they'd been there a while... .

Sometimes traffic patrol people help the hitchers out by stopping a truck or a car and inviting the driver to give them a lift. Tourist buses, even when half-empty, are not required to stop. And we were never on one, or saw one, that did.

If they can afford it, Cubans will travel between towns by 'Cuban bus.' This is sometimes a real bus, but more often it's a battered old bus body pulled by an even older tractor. Although tourists are not supposed to travel in these buses, we got a friend to buy us tickets on one so we could experience the ride.

The first part of our experience was very Cuban – waiting for two hours for the bus to leave. The bus was there at the station (a derelict parking lot), but either there was no driver, or we were waiting for more passengers. The Cubans all waited patiently – they are accustomed to long waits.

Finally it was time to get on board. The outside of the bus was a battered wreck. Its engine was non-functional, so it was being pulled by an old truck tractor. The inside of the bus was even more dismal. A few broken plastic seats on either side and at the front of the trailer were attached to the floor in the most rudimentary fashion.

There was a metal pipe railing running down the center of the bus for those who were standing to hang onto, or lean against. It was poorly welded to the floor. The floor itself was a patchwork of welded pieces, with gaps through which you could see daylight, and the road below.

The windows were filthy, like the rest of the bus, and were either permanently open or permanently closed. There didn’t appear to be any door on the bus, just an opening where passengers could get on and off.

But the ‘fare,’ for both of us, was 3 Cuban pesos, or about 15 cents (compared to the $30 it had cost us to get here by private taxi). It was worth it just to experience real Cuban transportation – dirty, smelly and uncomfortable.

Many times we saw livestock transport trucks with slatted wooden sides carrying human cargo. Everyone stands on these 'buses' – packed tightly enough together that they hold one another up through the swaying, bouncing ride over rough roads. There are no windows, just small spaces between the wooden slat sides. Almost always these ‘buses’ are packed to the gills, with peoples’ arms hanging out, and many sets of eyes peering out between the slats. Like so many horses, cattle, sheep or pigs being shipped off to the slaughter-house. So dehumanizing, so demeaning. And so very Cuban.

A few (young romantic revolutionary) tourists told us how much fun they had travelling in the open trucks and wagons. This was 'the real Cuba!' Locals, for whom there is no other option, told a different tale – of waiting in long lines for rides in crowded trucks. Of sweltering heat and sweaty bodies. Of choking dust in noses, mouths and eyes. Of hours holding babies and children so they wouldn't be crushed in the press of humanity. Of break-downs in the middle of nowhere, with no help.

Our friend Sylvia told us about her trips to see an obstetrician in a city about 50 kilometres from her village. She had a minor risk in her pregnancy that required her to have monthly check-ups by the obstetrician. For these visits she would get up at 4:30 in the morning, and be at the 'bus station' – the intersection of two streets in her town – by 5:00 am to wait for the 'bus.' No matter how early she arrived, there were always others before her, already waiting.

Sometimes Sylvia was lucky and managed to get on a bus with a few seats. Mostly she was not, and spent the ride standing. She showed us how she held on to the side of the truck, or the person beside her, with one hand, and cradled her belly, trying to protect it from the jarring bumping of the bus, with the other. The ride often took more than two hours. Her visits took ten minutes.

The Castros and their cronies – high-ranking politicians and military types – of course have cars like Mercedes or Toyota Pathfinders to take them whenever and wherever they want to go. Their cars are always black and highly polished, always new, and always guarded by a uniformed driver. When it comes to cars, it seems all communists are not considered equals.

But perhaps worse than the inadequacies and inefficiencies of motorized transport in Cuba is the pollution associated with it. First there's the noise: there are few mufflers, or functional mufflers, in Cuba. With vehicle parts so difficult to get, the focus is on the essential parts, the ones the vehicle needs to run. Transport trucks in particular can be deafening. You can hear and even feel them approaching – a reverberation deep in your chest – long before you see them.

Second, and more serious, is the air pollution created by all of the engines used to propel the various modes of transport. Because petrol and diesel are, relatively speaking, so expensive, Cubans cut their motor fuel with kerosene. Kerosene burns dirty – great plumes of thick black smoke belch from cars, trucks, buses and motorcycles – a noxious cloud that hangs in the air long after the vehicle's gone.

So despite the paucity of motorized vehicles on Cuba's roads, the noise and air pollution created by the few there are make living and walking in Cuban cities much less pleasant – and less healthy – than living and walking in many of the busiest cities in the world.

If you go to Cuba, one of the best things you can take with you is a bicycle. First, you can ride it around, but later, and more importantly, you can leave it with a Cuban. On one of our trips we took a couple of $35 thrift store bikes. When we gave them to our friend Yasser, he was ecstatic. “Never in my wildest dreams did I ever think I would own a bicycle like this!” He still talks about it.

Cuban Maternity Care: Worth a Closer Look

On our first trip to Cuba, one of our friends was around seven months' pregnant. She'd been told her baby was breech, and would have to be delivered by Caesarean section. For her and her family, which included some medical practitioners, this was not just bad, but frightening news.

“The hospitals in Cuba do not have proper equipment,” they told me. “You cannot count on things being clean. The material they use to stitch people up is often old, and falls apart. They often do not have the right drugs. They re-use disposable needles.” Their list of concerns was long.

I agreed to examine the woman in the presence of her husband. By my palpation, the baby was indeed breech, but it seemed mobile, and small enough to turn. I asked her if her obstetrician had suggested she do any exercises to help the baby turn to a head-down position. “No, he just says I will have to have a Caesarean section.”

I showed her the exercises, and was pleased to hear that at her next visit to the obstetrician he found that the baby had turned, and was now head down. She said that when she told him about the exercises he expressed surprise. He wanted to know who had told her about this, and what exactly she had done.

Before we left Cuba the family asked me to send some suture material, sterile gloves and needles and medications to prevent hemorrhage to them. These were the things they were concerned would not be available when the woman went, in labour, to the hospital. I sent the package, and they received it with no difficulty, and in time for the birth.

I was interested to talk with Cuban women about their childbirth experiences, and heard many stories. I was surprised by the number of women I talked to that had been delivered by Caesarean section – in my small sample of around 25 women they represented the majority.

The women were all happy to show me their scars, lifting their shirts and dresses even in the most public of places. All of the scars were vertical, from pubis to navel – the old 'classical' incision that is no longer used in the western world. Two obstetricians I met informed me that Cuban obstetricians are now performing lower segment transverse Caesarean sections.

In most western nations, women who have had 'classical' Caesarean sections are not considered good risks for subsequent vaginal deliveries as these incisions are associated with a higher incidence of uterine rupture. Repeat Caesarean section is generally the rule in these cases. Apparently it is not the rule in Cuba. Women with vertical incisions told me that they and others did go on to have subsequent vaginal deliveries. It would be interesting to know what the rate of uterine rupture is in these deliveries. Perhaps the Cubans know something we don't, or perhaps they are more willing to take these risks.

Just as disturbing as the vertical incisions these women had were the frequent signs of poor wound healing. Many of the scars were very wide and looked, even after many years, poorly healed. Several women spoke of having to go back to the hospital because their wounds had re-opened and/or become infected. Several women blamed poor quality suture materials as the reasons their incisions re-opened. Many women had taken months to recover from their surgeries, and needed mothers, sisters, aunties and friends to look after their babies for them.

But most disturbing to me of all was how little Cuban women knew about their bodies, about health and care in pregnancy, and about labour and delivery. According to them, care during pregnancy consisted of being weighed, measured and given an ultra-sound – at every visit! All of them had had blood tests done, although most of them didn't know what they were for. (In fact, from discussions I had with a Cuban geneticist, I learned that Cuba tests pregnant women for most of the same parameters, including the risk of genetic disorders, that we do.)

Women went into labour and birth with a 'knowledge' based on stories they'd been told by other women – often dreadful stories. They were fearful and distrusting. Of those who'd had Caesarean sections, not one of them knew the reason why. All of them just said “because they told me my baby was in trouble.” This is not so terribly different from women in the western world – it seems most maternity caregivers either believe that women are not capable of understanding more technical explanations or that the caregivers themselves are not prepared to disclose the real reasons, which in some cases may have little to do with the safety or health of either baby or mother.

Almost all Cuban women go to hospitals to deliver their babies. The Cuban government, like the governments of many developing nations, does not support midwifery. I neither found nor heard of any midwives practicing in Cuba. Women are cared for by perinatal nurses and doctors who generally have some obstetrical training. Cuba has many doctors – more doctors per capita than most western nations – and apparently many obstetricians. This may account for what appeared to be a rather high Caesarean section rate, although I was unable to get any statistics. (The Cuban government doesn't make such statistics easily available.)

The most impressive maternity service provided by the Cuban government is the system of 'casas de mujeres,' or maternity homes. We saw these homes in every city and town in Cuba. Women who live a distance away from a hospital, women living in 'suboptimal' domestic situations, or women with problems in their pregnancies that require observation, are given beds in these homes. They are also given three meals a day, which for some of them is more than they would get at home.

But most importantly the women in the 'casas de mujeres'' do not have to work. They have no husbands or children to look after, no chores to do. Given that almost everything is done by hand in Cuba, domestic chores often involve much heavy lifting – pots filled with water, baskets of wet laundry, toddlers who need to be carried. So for many women, their time in these homes is like a holiday.

It was wonderful to see small groups of women with big bellies sitting in rocking chairs on the verandah of an old colonial mansion with their feet up, chatting and laughing with one another. Husbands and families can visit of course, and we often saw couples sitting hand in hand watching tv.

The 'casas de mujeres' are staffed by nurses who are able to monitor the womens' health, and take the women to hospital as and when needed. This may be one of the most important things that Cuba does to achieve its very low infant mortality rates – the lowest in South America and lower even than the rate in Canada – a very impressive achievement.

Although Cuban women do get a full year's paid maternity leave when they have a baby, many of them go back to work within the first few months. It's the only way to make ends even begin to meet. The baby is either left with a mother or sister, or placed in an 'infant circle,' which used to be provided as a service by the government, but which now must be paid for.

There was little education about breast-feeding in Cuba, and little overt support for it. I was saddened to see the number of women who were bottle-feeding their babies. And I was amazed, given Castro's hostility to western capitalism, to see that Nestles appeared to have the corner on the formula market in Cuba.

Cuban Health Care: Doctors Without Bandaids

We had heard so much about Cuba's health system – one of the greatest successes of the never-ending Cuban revolution. More doctors per capita than even most western nations, health clinics in every neighbourhood, town, small village, health care free for all, and a world-renowned pharmaceutical industry. Our experiences uncovered a somewhat different reality.

On our first trip to Cuba I met a Cuban obsterician/gynecologist in a cafe in Havana. We enjoyed a long discussion about maternity care in Cuba, his work in the hospital in Havana, and his family – his wife and two young girls. When it was time to part, he took my hand, looked straight into my eyes, and said: “Please, I am wondering if you could give me some money. I do not get paid much for my work – not enough to support my family. Please, if you could help.”

On another trip I again met with a Cuban obstetrician/gynecologist. We had a wide-ranging discussion, during which it became clear that although he had been fairly well trained, his knowledge was limited by the fact that he had had very limited access to modern obstetrical or gynecological texts. At the end of our conversation, this doctor said: “I do not ask you for money. I ask you for information. Please, if you can send me information. Here it is so difficult to get.”

The doctor told me he was unable to get any obstetrical or gynecological journals, and was permitted only one hour a week of internet access – and even that was restricted. He therefore had almost no way of keeping current with advances in his field, or of getting information about specific disorders, problems or issues he was encountering. And he is a 'specialist.'

We frequently saw people with nasty open wounds and sores in Cuba. On several occasions I asked them if they'd been to a clinic to have the wound treated. The answer was either “yes, but they had no ointment and no bandages” or “no, I didn't bother - they have nothing there.”

On one occasion we were helping a group of carpenters with a community project when one of the workers gashed his finger. The cut looked like it was almost to the bone: the last joint of his finger was hanging at a sickening angle. He went to the local clinic where the wound was cleaned and sutured, but the clinic had no gauze or plasters to cover it. Within a few minutes back at work, the unprotected wound re-opened. All of the sutures had given way. Franco was adamant that he would not return to the clinic.

I offered to help, using limited supplies from our travelling first aid kit. I applied a liberal glob of antibiotic, antibacterial ointment to the gash and used some gauze and a couple of well-wrapped band-aids to protect the wound and hold the finger-tip straight with the rest of his finger. Franco went back to work.

We saw him several days later, in town. He ran over to show us his finger. It was healing very well. The cut was closed, and the finger was straight. I gave him another couple of band-aids to keep the finger protected as he worked. Wherever we went in that town from then on we were greeted with big smiles and hand-shakes. The story of the gringos who had effected the miraculous healing of the carpenter's finger had spread by Cuban 'telephone' – word of mouth – surely one of the fastest communication systems in the world.

On another occasion we were walking near a pharmacy. A young man approached us and asked if we would give him the money to pay for a prescription. We asked him if he couldn't get his prescription for free. “No, nothing is 'free' here in Cuba. It doesn't cost much, but anyway I don't have the money.” As it turned out, the drug he needed didn't cost much at all, by our standards. But on his salary, $8 or $9 a month, even $2 was too much. We bought him the prescription.

At one of our bed and breakfast places, the woman's daughter had insulin-dependent diabetes. She had great difficulty controlling her diabetes not because she couldn't get the insulin – it was available. The problem was that the diabetes centre in central Havana, although it had the testing kits needed to determine one's blood-sugar level, almost never had any testing strips. The kits are useless without the strips.

So for the woman's daughter, as for other diabetics in the country, treatment of diabetes is based on guess-work. What do I think my blood-sugar level is? How much insulin do I think I need? This is a dangerous way to treat diabetes. And diabetes rates are reportedly high in Cuba, likely due to the low protein and high carbohydrate nature of the Cuban's limited diet.

In Havana we met a traveller from Finland who had a truly awful throat infection. He had been seen by a Cuban doctor at an ''international clinic,' and been given a prescription for a antibiotic muscular injection. A clinic nurse had given him the first shot – in the butt. He said it was extremely painful – a burning sensation that went right down his leg and lasted long after the needle was withdrawn.

I looked at the vial of medication. It was an antibiotic that's meant to be given intravenously, not intra-muscularly. I offered to give him the rest of his injections, but warned him that regardless of the technique of the puncturist, the shots were going to hurt.

The clinic had provided him with enough disposable needles and syringes for five more shots, all of which I gave him (and all of which hurt, but not as much as the first one – I injected the drug slowly). As a medical practitioner, I was concerned about safe disposal of the needles. We were all staying in a casa particular where one of the family members was a doctor. I asked her if she could dispose of the needles. “No hay problema!” she replied. No problem.

When I gave the used needles to her, she turned around and tossed them into an open waste basket in the corner of the room she shared with her two small small children. They were playing on the floor not a few feet from the waste basket. I wondered how needles were disposed of in Cuban hospitals and clinics... .

On our last trip to Cuba we were told about Fidel's arrangement with Bolivia. Bolivians come to Cuba for eye surgery. Once it's done, they stay at one of the all-inclusive resort hotels to recover for a few days, or a week. The same hotels that are off-limits to Cubans.

We asked a few Cubans what they thought about the 'free' health care and hotel stays for Bolivians. They all expressed pride in Cuba's modern – and obviously superior – health care system, and in Cuba's generosity in providing this service 'free' to Bolivians. Only a couple of them seemed aware that the Cuban government was in fact being paid.

The Cuban government also has an arrangement with the Venezuelan government – doctors for oil. Cuban doctors, having received their education courtesy of the state, must pay it back by going to Venezuela for two years – or more – to work. This often results in the separation of families – mothers and fathers leaving husbands, wives, babies and children behind in Cuba as they go off to Venezuela for their tour of duty.

The Cuban doctor in Venezuela does get paid for his or her work – and very well by Cuban standards: around $50 a month. For their families, this is a tremendous benefit. The doctors can also, while they're in Venezuela, buy all sorts of things that are simply not available in Cuba: electronics, kitchen appliances and utensils, clothes, shoes, cosmetics, jewelry – and food, glorious food.

But regardless of the perqs, the Cuban doctor is indentured to the state. When he or she is 'invited' to go to Venezuela, it's an invitation that can hardly be refused. We met several doctors who had gone to Venezuela for more than one two-year stint. One of them had been away from their family for six years. The doctor was estranged from his wife, and hardly knew his own children, nor they him.

Despite its undeniable successes, the Cuban health care system has some serious problems and short-comings. Unfortunately these cannot begin to be addressed until the Cuban government is willing to listen to concerns and criticisms from within the system, and to accept help and advice from outside.

Cuban Education

To view more of Ruby's photos of Cuba go to

Cuban Education: 1 Che X 1 Fidel = 1 Revolution

The Cuban education system is deservedly world renowned. All Cuban kids go to school: education is free, and learning highly valued. Even the smallest and most remote villages have schools and teachers. Many Cuban youths go on to higher education in one of the island's many colleges, universities or technical schools.

Cuba boasts a 99% literacy rate. Given that 'literacy' may be defined simply by the ability to write one's name, it's difficult to know with certainty what this means. However when we were travelling in Cuba between 2003 and 2008 we saw many Cubans reading, and met lots of individuals with advanced degrees. (Unfortunately many of them were working at jobs that required little education – doctors driving taxis, architects working as prostitutes.)

On our trips we also met several school teachers and a few university professors. We peeked into a couple of schools. For us it was, like much of our Cuban experience, like stepping back in time – to 1950, or even before.

All grade school pupils in Cuba wear uniforms – white shirts with red bandanas and tan shorts, slacks or skirts. They look like Liliputian armies, especially when they're out in the local square, practicing their marching skills. Eagle-eyed sergeant-teachers bark out commands, and stern corrections to those pupils who aren't perfectly in time, aren't lifting their legs high or straight enough in the typical communist goose-step, swinging their arms in the prescribed manner, or holding their chins high enough. Marching is clearly serious business. Many of these children will go on to cadet schools and military service which, although not compulsory, is strongly recommended.

The regimental atmosphere is also evident in the classroom. Twenty to twenty-five students sit in desks arranged in straight rows, all facing the teacher and the chalk-board. The style of teaching is didactic – the teacher talks, the pupils listen. We saw none of the active, hands-on, group project kinds of activities that have come to characterize the western education system.

From what we saw, it appears that Cuban education relies on repetition, drill and memorization – writing the same words or phrases over and over, memorizing mathematical tables, poems, quotes by Cuban heroes, long lists of names and dates, countries and capital cities. Teachers teach according to a strictly proscribed curriculum, using standard government-issue texts.

The early reading books look much like the old 'Dick and Jane' books we learned from over 50 years ago. Other text-books we saw were very dry indeed – none of the colourful pictures, maps, or diagrams that enliven the pages of modern western text-books – just paragraph after paragraph and page after page of printed words. I can hear my kids' complaint – “it's so boring!”

We had an opportunity to look at the school note books of several different ages of kids. They all looked like something out of the 1950's.

Teresa was in kindergarten. Her writing book contained several pages of straight lines drawn between the lines on the page. From the first to the last, all of them were perfectly straight. It was hard to imagine what was gained through such tedious repetition. After the straight lines came pages of loops, such as l’s and e’s. Again, from first to last, all were carefully executed, their bottoms sitting on the line below them, the tops of the l's touching the upper line, the tops of the e's exactly half-way between the two lines. Then pages of o’s. It looked dreadfully tedious – hard to imagine a five-year-old with the patience to repeat something so basic – and something they had clearly mastered in the first line – over and over.

Teresa's parents showed us the educational materials that they are required to make at home. One of the items was a multi-pocketed piece of fabric which contained four basic shapes – a circle, a triangle, a square and an oval – in four or five different colours. These are apparently meant to help the child learn colours and shapes. But as Teresa's parents pointed out, Teresa and the other children knew their colours and shapes before they got to kindergarten.

Teresa's parents told us that the coloured shapes are also used in a new language program. The kids are supposed to break down all the words they learn into individual sounds, making the sound of each individual letter. So, the Spanish word “sol” becomes esse, oh, elle. As each letter is sounded, the kid pops one of the shapes into one of the pockets – presumably as a reward. We wondered how this approach helps with the acquisition of language. Perhaps it's a new approach to spelling.

Luis was in grade 4 or 5. He had several notebooks – for arithmetic, language, social studies and geography. His arithmetic book contained neat additions, subtractions, multiplications and divisions of numbers up to 100. He could also recite his sums and times-tables. His parents drill him every evening. Although he was facile with the tables, it was not clear to me that Luis actually understood the concepts that underlay them – one of the problems of rote-learning.

All of Luis' notebooks contained endless political references – references to various heroes of the revolution and the greatness of Cuba. There was not one page that did not contain something about the political history of Cuba.

According to the teachers we talked to, there must be approved political content in every single class: 1 Che X 1 Fidel = 1 Revolution. Inspectors visit classrooms frequently, and unannounced, to make sure teachers not only abide by this 'golden rule,' but that they do so with the proper amount of zeal and fervor: 1 Patriot-Martyr Che X 1 Fearless Fidel = 1 Glorious Revolution! More than education, this is indoctrination.

The Cuban government is a great supporter of the arts. In one town the local cultural centre offers art lessons to school children. We visited the centre and saw a small group of children, all sitting at large tables, quietly – and carefully – painting. The instructor, a rather severe-looking older man who never once smiled, went round offering advice to each child. “Paint this part of the house a darker grey,” “put feet and shoes on this person,” “what are you going to put in this place?”

The children made no response, but dutifully followed his directions. Their paintings were very colourful, and filled the entire sheet of paper, which was good. But there was no spontaneity in them, and certainly there didn't seem to be much fun in doing them.

It is undoubtedly true that the Cuban education system turns out students who can read, do their maths, and spout all sorts of facts. But what about critical thinking? Indeed, what about independent thought at all? When we were in Cuba we only very rarely came across someone who demonstrated an ability to do anything other than follow the rules, no matter how nonsensical or down-right ridiculous they were. This is of course partly because Cubans are afraid to do or say anything they have not been told to do or say. In Cuba, independent-mindedness and action often attracts the wrong sort of attention.

Consider this: no foreign newspapers are available in Cuba, except perhaps at some of the most upscale hotels, although even there we did not see them. No magazines, except the few that are brought in by tourists, friends and family – generally magazines like 'People,' 'Chatelaine,' and 'Cosmo.'

All books must be approved by the Cuban government – any that contain content deemed critical of the country, or the revolution, are banned. Television and radio broadcasts from the USA and Europe are scrambled – we had difficulty getting any reception at all, even with our short-wave radio.

I talked to several doctors, and a few other professionals, who said that their biggest problem was getting information. They were taught using dated, and often shared, texts. They could not afford to subscribe to appropriate professional journals, and their internet access was severely restricted. We would likely not consider them properly trained, and they had no way to remain current.

How educated can a people be when they have almost no access to information? When there is only one government-controlled newspaper? When almost all of the 'news' is still about the revolution, some 50 years ago, but spoken of as if it were yesterday? When any news about the US or the western world is painted in the blackest possible terms, and all 'news' about Cuba glows with praise and pride?

How educated can a people be when they are afraid to really speak their minds? When they retreat inside their homes and turn the music up loud to mask 'subversive' conversations among themselves or, more dangerous yet, with foreigners?

How educated can a people be when they are not allowed to think? The Cuban people often reminded me of children: they have been told what to do for so long – 50 years, at least two generations – that many seem to have lost the ability or desire to think for themselves.

The Castros and the Cuban Housing Crisis

Recently on CNN I watched a news clip about Cuba. A young middle-aged woman was showing the camera man her 'home' – one small room under the stairs. No plumbing, no bathroom, no kitchen. “I go to my mother's house to use the facilities,” she said.

This reminded me of Martha, a woman I met in a small town in Cuba in the spring of 2008. She and her teen-aged daughter were living in what had been a physician's consulting room – an eight foot by twelve foot room with a very small window, no plumbing, and of course no bathroom or kitchen.

Martha went to a friend's house, some two or three blocks away, to use the facilities. Her relationship with her daughter was becoming increasingly strained. Sometimes her daughter chose not to come home at night, staying with 'friends.' Her mother worried where this might be leading.

The reason the news clip was on tv was that Raul Castro, the same Raul Castro, brother of Fidel, who executed hundreds of Cubans during 'the revolution,' has recently announced that Cubans are now permitted to renovate their homes – as long as they use their own money. Read: money from family and friends outside the country.

Raul also said that the Cuban government would supply building materials. What exactly is meant by this is yet to be seen. Anything and everything that Cubans buy must, according to the restrictive communist regime they live in, be purchased from the government. There is of course a thriving black market, dealing mostly in materials stolen from government warehouses.

The clip made it sound like Raul is going to make building materials available without cost. That's of course how the Castro government wants it to sound, how all of their 'good news' pronouncements sound. But the reality is often quite different. And if building materials were truly going to be made available for 'free,' why would Cubans need money from abroad to renovate their homes?

Raul also pointed out, and this may be the hitch for many Cubans, that the renovations must be consistent with government plans for the house or building. A Cuban friend of ours recently renovated his house – a free-standing house in a small town in Cuba that only he and his family live in.

Although none of the renovations (replacing a leaking roof and old see-through wooden slat walls) changed either the exterior footprint of the house or the configuration of the interior space, our friend had to wait over a year for the necessary permits to proceed with his work.

Communist bureaucracy is even slower – and much more officious – than capitalist bureaucracy. Petty, nit-picking and requiring endless palm-greasing and back-scratching. Things only go smoothly when you have 'friends' in the system.

To understand the housing situation in Cuba, one has to first understand that all housing is owned by the state. The state assigns housing to its people. This family gets a house, this family an apartment, and this family just one room. Living conditions are often extremely crowded, with up to a dozen people sharing one small apartment. They sleep in shifts.

Unfortunately a number of Cuban homes and buildings were vandalized and destroyed by Cuban revolutionaries – and have never been repaired. Our friend Elena's family's home was commandeered and occupied by the revolutionaries for several years. They threw garbage and machinery down the well, destroying its forever. They broke and burned most of the furniture, and they left the house in a state of complete disrepair. The family, having no money to repair it, has simply had to live with it as is – a constant and sad reminder of what the revolution meant to them.

Furthermore, there have been very few additions to, or renovations of, the housing stock since the revolution in 1959. Some astonishingly ugly concrete slab apartments were constructed during Cuba's period of dependency on Russia, in the 1980's. In addition to being architectural eyesores, these buildings were poorly constructed. Most of them are now cracked and crumbling ruins. Plaster is crumbling, paint faded and peeling, old tiles broken or missing altogether. Windows and doors are battered and broken; stairs rickety and unsafe. Rooves leak, plumbing is non-existent or non-functional and electrical supply and connections are shockingly (literally) unsafe.

Many people living in Cuba's largest cities, like Havana and Santiago de Chile, are simply camping in derelict buildings, many of which have been condemned as 'unfit for human habitation.' But there is nowhere else for the people who live in them to go. There is simply no other housing available.

Some Cubans are homeless. We saw them sleeping in parks and in doorways – sheltering from sun and rain under scavenged pieces of cardboard. Almost always they were older men; a few were women. We saw no homeless children – but we cannot say with certainty that there are none.

In rural areas, mud huts with corrugated tin rooves are common. They have dirt, or in the wet season mud, floors and no windows. Their small dark interiors usually have only one room. The 'kitchen' is a collection of pots and utensils hanging on an outside wall, and an open fire somewhere nearby. There is no bathroom, and often no outhouse – just the great 'outdoors.'

Because of the lack of plumbing in so many homes and apartments, Cuban parks, beaches and empty lots have all become public latrines: a dreadful and disgusting health hazard for all.

Of course there are some better houses and apartments in Cuba, some which have been kept in better repair. But even in these, plumbing fixtures are old – and often temperamental. Hot water heaters are almost unknown. Few houses have proper 'kitchens' – more often just an old sink and a make-shift camp-stove with a bottle of kerosene hung overhead. The kerosene is gravity-fed through a length of recycled surgical tubing. Unbelievably dangerous, but it works.

In Havana and in other cities and towns around the island there are a few really upscale, and even opulent hotels, houses and apartments. Most of these are older colonial buildings, with fantastic colonnades, balconies, marble floors and tile rooves. They have been painstakingly restored, at considerable expense, and almost always by foreign governments, corporations or individuals. They stand in stark contrast to the crumbling and decaying structures around them.

These beautiful buildings are used either by foreign interests, as embassies or luxury getaways, or as hotels or high-end shops, or by the Cuban government and military. The foreigners at least keep their buildings in good repair, take care of the grounds around them, and make good use of them.

The Cuban government, on the other hand, having appropriated many of the nicest buildings in the country, now uses them as headquarters for myriad – and often inexplicable – government functions. Often this amounts to almost no use at all – a few tired-looking employees sleeping at their desks, guarded by an officious-looking guy in a military uniform at the door.

Upkeep of the Cuban government's buildings is minimal. Some have received new coats of paint, but interior and exterior walls are often plastered with revolutionary posters and slogans, and doors and windows are often broken or boarded over. The grounds and gardens have almost always been let go, with either scraggly grass and weeds or an expanse of parched dirt or mud bordering a crumbling cement entryway. Truly pathetic.

To be sure, a few Cubans have managed, with money sent from family and friends outside the country (often big bad America), to renovate or build new houses. Some are able to do it using money they make working with and for tourists – and getting paid in convertibles, the currency used by all tourists in Cuba. One convertible is worth over 25 times more than the Cuban peso. These Cubans are the envy of all. In some cases their 'good fortune' creates bitter divisiveness among families and communities.

But for people like Martha and Elena, dependent on state salaries, which range from $US 8 to $US 35 a month, and which is paid only in pesos, renovating homes is completely out of the question. Their salaries are not even enough to put food – poor quality government subsidized and rationed food at that – on the table.

Raul will have to come up with something more substantial than 'allowing Cuban people to renovate their homes (which will still be owned by the state) with their own money (mostly from sources abroad),' if he intends to truly address the housing crisis in Cuba. But perhaps that is not his intent.

Perhaps Raul's announcement has more to do with appearance than substance. Like his recent announcement that Cubans are now permitted to purchase cell phones and DVD players. As several of our Cuban friends have said, “with what money?”

Raul needs to put his money where his mouth is. Until the Cuban people have enough money to live – to eat and to house themselves – all his pronouncements are no more than bitter pills, cruel reminders to his people of what most of them cannot have.

The Cuban Ration System: A Look Inside the Libreta

“'On the cooking show today they showed how to fry a steak from a grapefruit skin,' her mother said. 'They turned a grapefruit skin into steak. Isn't that amazing? This is a revolution that is more amazing all the time.'”
from 'Havana Bay' (1999) by Martin Cruz Smith p. 48

The 'Libreta' and the 'Periodo Especial'

The title on the Cubans' ration booklets reads: “Control de Ventas Para Productos Alimentos” (control of sale of food products). Food rationing was introduced in the early 1990’s, after the collapse of the Soviet Union. The Soviet purchase of Cuban sugar at significantly higher than market prices, abruptly stopped. Soviet investment in and aid to Cuba likewise evaporated. As Cuba had been entirely dependent on the Soviet Union, and before that on the United States, this led to the complete collapse of the Cuban economy.

When Castro introduced food rationing, it was part of a larger program of austerity measures that he called the “periodo especial” (special period). Castro exhorted his people to tighten their belts. He did not, as did the leaders of other countries that had been dependent on the Soviet Union – countries like Vietnam, Cambodia and the countries of the 'Eastern Block' – encourage more individual industry and small scale agriculture as these countries did.

There would be no softening of the iron grip of communism in Fidel's Cuba. The state maintained control of all agriculture. And the state was in a mess. Cuba could neither grow or produce enough food for its people, or import enough. It was during this time that Cubans resorted to eating fried grapefruit skins, insects and worms. Food rations were simply not enough to keep them alive.

Although food rationing was introduced as a 'temporary measure,' it has continued now for almost 20 years. The 'periodo especial' has turned into an 'epoca especial.' And there is no end in sight.

Food rations are not free, but they are subsidized. Rationed foods are of uniformly poor quality; the amounts provided for each individual are not enough to sustain them, and certainly are not varied enough to represent anything resembling a 'balanced diet.' Cubans must look elsewhere to supplement their diet. Unfortunately, there is almost nowhere else to look.

At the beginning of each year, all Cuban families – people who are living together under one roof – are issued new 'libretas,' or ration booklets. The various pages of the booklet are used to record what an individual and a family is entitled to, and what it has bought.

We looked at the books of a couple of families in a small town, and have used these as the basis of the following list of items available through the ration system. Apparently these items may vary from place to place. Cubans from small towns consistently told us that the people of Havana are able to get many more things with their ration cards. From what we could see, this appeared to be true. Food is a little more plentiful in Havana. But it is still scarce. Frequently some of the things Cubans are meant to be able to buy with their 'libretas' are simply not available.

In the novel 'Havana Bay,” Martin Cruz Smith paints a humourous, and deadly accurate, picture of the Cuban ration shop, or 'bodega,' and the chronic food shortages within the ration system:

“The bodega was a warehouse with the dimmest light in Havana, and the fact that the lines were short and Ofelia was going to do the mule's work of carrying a sack of Vietnamese rice and a tin of cooking oil did nothing to improve her mother's mood. ...
'We're almost there.' Ofelia fixed her eye on the counter.
'We're almost nowhere. This is nowhere, hija.'
There were four counters in the gloom of the bodega, each with a chalkboard that listed goods, prices, ration per person or family, and the date available, the 'date available' clouded from many corrections.
'Tomatoes next week,' Ofelia said. 'That's good news.'
Her mother exploded with a laugh. 'My God, I've raised an idiot. There will be no tomatoes, no evaporated milk, no flour and maybe no beans or rice. This is a trap for morons. '
At the counter her mother made a show of having her book properly marked and announcing, 'You know, if you live on your rations you will enjoy a very balanced diet.'
'That's true,' one of the clerks was stupid enough to agree.
'Because you eat for two weeks and starve for two weeks.'”

from 'Havana Bay' (1999) by Martin Cruz Smith p.p. 300-301

Food and other items available through the 'libreta'

The following is a list of items we found on the ‘libretas’ we looked at, in January of 2008, along with the prices for each item, in pesos, the money in which Cuban workers are paid. Prices on the black market, which often trades in foods stolen from government warehouses, are much higher. Where I was able to get them, they're indicated in brackets. I have also included some notes about the nature or quality of the food item, from what I observed directly.

Each individual, each month is entitled to buy:
White rice: 5 pounds at 1.25 pesos per pound (5 pesos per pound on the black market)
rice is THE staple food, 5 pounds would make about 20 meals for one person
the bags of rice we saw were from Vietnam, and labeled 'broken rice'
Sugar: 5 pounds at 0.25 pesos per pound (6-7 pesos per pound on the black market!)
sugar may be white and/or brown, depending on what’s available
the sugar we saw was from Cuba, although Cuba does import sugar
many Cubans drink sugar-water to increase their caloric intake
Salt: 1 pound at 0.25 pesos per pound (0.80 pesos per pound on the black market)
Dried black beans: 10 ounces for 0.25 pesos (5 pesos for the same amount on the black market)
this is enough for about 2 meals, and is the primary source of protein for most Cubans
the beans often contain many little rocks and twigs, which must be picked out by hand
Eggs: a total of 10, the first 5 at 0.15 pesos each, and the next 5 at 0.90 pesos each (2 pesos a piece on the black market)
Fish: 6 ounces for 0.40 pesos (20 pesos per pound on the black market)
the fish were extremely small and bony, something we might use as bait
Cooking oil: 8 ounces for 0.20 pesos (45 pesos per litre on the black market)
Ground coffee: 4 grams for 5 pesos (20 pesos per gram on the black market)
the coffee was of extremely poor quality, mixed with peas or lentils

Each individual, every 15 days, is entitled to buy:
'Meat product:' 8 ounces for 0.50 pesos
this ground meat products includes all edible parts of an animal, including the eyes, heart, brain, etc.
it looks and tastes disgusting – we agreed with Cubans who said it was worse than Spam (Spam is sold in 'dollar stores,' but is too expensive for most Cubans to buy)
there is no black market for this product as no Cuban would pay any more for it than the subsidized government price
Bath soap: one bar for 0.25 pesos
not always available, and very poor quality
Laundry soap: one bar for 0.25 pesos
not always available

Each individual, every day, is entitled to buy:
White bread roll: 1 small bun for 0.05 pesos a piece (0.50 pesos on the black market)
Cubans must go to their local 'panaderia' or bakery to buy their one bun; queues are often long
bread is at least baked fresh daily, but has little food value

Each family, per month, is entitled to buy:
Toothpaste: 1 tube for 0.65 pesos
poor quality, and often not available

Occasionally, when it's available, families may be able to buy pasta – around 4 ounces per person. According to the people we talked to, this happens between 2 and 4 times a year. In December of 2007 families were able to buy one pound of cornmeal per person. This was particularly appreciated as cornmeal tamales are a traditional part of the Cuban their New Year’s dinner.

When the weather is unusually wet, each individual may be able to buy an additional 2 pounds of rice and 2 pounds of peas, and each family of four may buy one can of meat (often hot dogs). Some years, individuals are able to buy 8 ounces of 'real' meat, not meat product, but that didn't happen in 2007.

Although tinned tomatoes and crackers are listed in the 'libreta,' no one we spoke with to has ever seen these in a ration shop. Similarly toilet paper, listed in the 'libreta,' has never been available. Cubans use newspaper, or whatever other scraps of paper they can find. Some of them told us how they particularly relish using newspapers with Castro's photo as bum-wipe. Even using a page with one of his many interminable articles gives them some satisfaction.

When they are menstruating, Cuban women must take their ration cards and their ID cards to the store in order to be able to purchase sanitary napkins. Packages of these - enough for one cycle – cost just over one peso.

There are special rations for children:

Each child under the age of 7 years, every day, is entitled to buy 100 grams of powdered milk at 1.25 pesos per packet (20 pesos per packet on the black market)
Each child under the age of 7 years, every 15 days, is entitled to buy 8 ounces of ground meat product or chicken, every 15 days, at 0.50 pesos a packet (chicken is 23 pesos per pound on the black market; it is seldom available through the ration system)
Each child under 3 years of age, per month, is entitled to buy 4 small tetrapack boxes, similar to individual drink boxes, of pureed fruit
Each child between the ages of 7 and 13, every other day, is entitled to buy 500 ml of soy at 1 peso per packet (3 pesos per packet on the black market)

School children are also given one 'vitamin-enriched' biscuit each day. The biscuits looked and tasted like cardboard, and were tooth-breakingly hard. We saw many in the gutters of the streets near schools, where even Cuban dogs turned up their noses at them.

There are also special rations for pregnant women, sick people and people with special dietary needs. They may be entitled to a little bit more of some things, and a few additional items such as powdered milk and yogurt.

Buying Food outside the Ration System

Obviously the ration system provides only the most basic food staples: no fresh vegetables or fruits, no flour, grains or cereals, no fresh dairy products, no condiments, and certainly no “frills” such as nuts, crackers, or juices. Vegetables, fruits, meat and fish must be purchased either at local farmers’ markets (which in our experience were few and far between, and had pathetically few things for sale, most of poor or very poor quality), or on the black market.

Other products, such as dairy products, frozen chicken and pork, canned and packaged goods and juices, may be purchased in 'dollar stores,' where all of the prices are in 'convertibles.' 'Convertibles' are the 'other' currency of Cuba – the currency that all tourists must use for their transactions.

By way of explanation, 'convertibles' were introduced in the early 1990's, and were originally based on the American dollar, with one 'convertible' being equivalent to one dollar. (Hence the term 'dollar stores.') But Castro, in another fit of pique with the USA, recently decided the 'convertible' should be based on the Euro. In January 2008 one 'convertible' was worth 27 pesos.

The prices of foods and goods in 'dollar stores' appeared to be similar to, or higher than, the price we would pay for a similar, but higher quality, product in Canada. The only Cubans who can afford to buy things at these prices, and in 'convertibles,' are the Cuban elite – high-ranking politicians and their friends, and the military – or 'regular' Cubans who either have family or friends who send them money regularly or who work in some aspect of the tourist industry, which gives them access to tourist 'dollars' or 'convertibles.' That is not most Cubans.

Furthermore, it appeared that at least some of the food being sold in the 'dollar stores' was food that had been given, by countries like the USA, Canada, Spain and others, as food aid. In our several trips to Cuba we never saw, or heard of, any food aid being distributed to the Cuban people. Some of it may go directly to the Cuban elite – high-ranking politicians and their friends, and the military.

Similarly, used clothes and shoes that are donated to Cuba are sold in the very few shops that are allowed to sell clothes. Certainly these clothes are cheap by our standards, but they are used. Our friends told us that once one of their friends found $10 in the pocket of a pair of jeans, and another found a gold chain. Would that all of them could be so lucky!

Basic Living Costs vs Average Incomes

It's interesting – and alarming – to compare the cost of living in Cuba with the incomes of the Cuban people, not all of which, despite the communist economy, are the same. Far from it! The putative 'minimum wage' in Cuba, which is what most Cubans earn, is 200 pesos or around $8 A MONTH. The highest wage we heard of, made by specialist doctors like obstetricians and geneticists, was 500-600 pesos, or around $35 per month.

Assuming a family of four, with one child under 7 years of age and one over (no children under three), the cost of buying the basic staple foods available through the ration system, for a one month period, would be just over 120 pesos. Let’s also assume the family “tops up” their rationed food with food purchased on the black market – say another 5 pounds of rice, and another half pound of beans per person (no meat or fish). That would be another 240 pesos. And let's say they buy a few tomatoes, cucumbers, cabbages, plantains and maybe a couple of oranges or bananas. Our Cuban friends told us that might cost another 40 pesos.

So for the most basic dietary items, the total cost is 400 pesos per month. That's twice what one Cuban making a minimum wage would earn, and most of what a 'high-paid' Cuban would earn. Clearly food 'treats' are out of the question: a small container of ice-cream costs 20 pesos. That’s a half a day’s wages.

What about other expenses? The Cuban government owns or controls all housing stock in Cuba. It assigns housing to families, some of whom are in fact still living in their old family homes. Some of these Cubans do not pay rent, but many Cubans, especially those living in apartments, do. And all must bear the costs associated with maintenance.

There are also such expenses as electricity and telephone. In a typical month, a family of four might have to pay 75-150 pesos for electricity, and 40-100 pesos for their phone. At the moment, Cubans do not pay for their water, but they are anticipating that this cost may also soon be added.

Additionally, the government of Cuba just recently required all Cubans to buy new, more energy efficient refrigerators. Their old ones were taken away; no one knew what had become of them. For their new fridges, Cubans must pay almost 60 pesos a month for a period of 6 years.

If we take the minimum amounts for electricity and phone, and assume one fridge (which many families do not have), the combined costs per month, not including the costs of renting or maintaining a house or apartment, would be around 580 pesos per month – well beyond what two workers getting minimum wages could earn, and all of what a top wage-earner might earn.

And this is before buying other necessary items such as household supplies, clothes, shoes, school supplies, medications, and the costs of transportation. Consider that a pair of shoes for a grown child or an adult costs 500 pesos. That’s a more than two months' wages for most Cubans.

This is also before paying for child-care, which used to be free, but now must be paid for. In many towns and cities, there are not enough places within the government child-care system for all of the children who need it, so some families have to pay even more for private child-minders.

Several of our Cuban friends told us that they would like to put Fidel and Raul Castro on a deserted island and give them only the food available through the ration system and see how long they would last. (This seemed to be a common Cuban 'dream.') They believe, and I heartily agree, that they wouldn’t last a minute. There is no way either Fidel or Raul, or anyone else with any self-respect, would eat the appalling crap that is SOLD to Cubans.

But to me the most degrading thing of all is the 'bone trucks.' Cubans are not permitted to eat beef, or to have it in their possession. All beef goes to tourists at the all-inclusive hotels and resorts – and of course to the Cuban 'elite.' After the meat's been scraped from the bones, the bones are collected. Once every week or two, a truck is filled with bones. It arrives at a town or village near the hotels and resorts and SELLS THE BONES to eagerly waiting Cubans. Our friends would get up at 5 in the morning to go and wait for the 'bone truck.' Sometimes it came, and sometimes it didn't. There was no way of knowing if or when it would come, so they waited every Saturday, just in case.

The image of Cuban government employees standing in the backs of trucks and selling scraped-bare bones to their fellow-countrymen is indelibly etched in my memory: it reminds, of course, of throwing bones to dogs.

Castro's callousness towards his own people, and in particular to their basic right to a reasonable diet, seems to know no bounds. Before we left Cuba we were told that Castro had declined an offer of food aid by the UN, saying that Cuba didn't need it. And undoubtedly he and his friends do not. But we know plenty of Cubans who would be very glad of it indeed.

A short vignette from 'Havana Bay,' again humourous, provides insight into how the ration system, combined with Castro's iron-fisted communist policies and regulations, affects the people of Cuba.

'She violated my trust. I took only my best students to the farm. To learn of the struggle in the countryside. Instead, she revealed herself as an anti-revolutionary and a thief.' Miss Garcia set a paper bag on her desk. 'On the way back on the bus this fell out of her shirt. I heard it fall.'
Ofelia looked inside the bag. 'A banana.'
'Stolen goods. Stolen by a daughter of an officer of the PNR. This is not going to end here.'
'Actually, a banana skin, no?' Ofelia lifted it from the bag by its unpeeled end. The skin was brown and blotchy, ripeness on the edge of rotting.
'Banana or banana skin, it makes no difference.'
'She had eaten it or not?'
'That doesn't matter.'
'You heard it fall. It's not likely you would hear an empty banana skin fall on a moving bus.'
'That's not the point.'
'Whose custody has it been in? There could be more than one person involved, there might be a whole ring involved with this banana. I will test it for fingerprints inside and out. We can do that. I'm glad you brought this to my attention. Don't worry, we'll get them all, each and every one. Do you want me to?'
'Well.' Miss Garcia sat back, and her tongue dabbed at the corner of her mouth. 'It was in my custody, of course. I don't know how it got eaten.'
'We can investigate. We can make sure the perpetrators never show their faces in this school again. Is that what you want?'
Miss Garcia looked aside, the eyebrows settled, and she said in an entirely different voice, 'I suppose I was hungry.'

from 'Havana Bay' (1999) by Martin Cruz Smith pp. 267-268