I have just returned from the Society for Medical Anthropology meeting in Havana which went ahead just days before the bans and restrictions on travel intensified. Going to Cuba after nearly a 12 year absence was not only an opportunity to reflect personally on the changes that have happened there since my last visit, which are numerous and fascinating, but also a chance to observe how it is responding to and managing the COVID-19 situation. The contradictions of Cuba are well known, yet they are also playing into and shaping the current moment. This includes a world renown and highly promoted state socialist public health system that has had great success in some areas such as maternal health indicators, but yet also depends on informal economies of exchange as well as the private resources and resourcefulness of individuals and families. There is nonetheless a history of some success in tackling infectious diseases, such as Dengue. Yet as I recall from the comprehensive and compulsory spraying of chemical insecticides in the streets and cities when I worked in Cuba, this comes with heavy handed state interventions. This includes in the 1990’s the enforced quarantine of those identified or suspected of being HIV+ . The ‘special’ situation of Cuba provides (yet again!) an opportunity to reflect on some the truly disorientating moments we are living through.
‘Cuba without COVID-19 and with an effective plan for confronting it’ read the headline on the 11th March in the daily state newspaper Granma. Indeed arriving at the state subsidised hotel in the west of Havana at the start of the conference there was little sense of coronavirus planning or heightened anxiety. The conference itself was somewhat depleted with many international delegates from Europe and the US deciding to stay away for anticipated logistical reasons to do with institutional restrictions or concerns about travel or family. I had reasoned that given that there were currently no cases in Cuba and it meant only being away for just over a week, things weren’t going to deteriorate that quickly, or so I thought. But as the conference kicked off there were subtle shifts in behaviour as news filtered in of an escalating situation in Europe and more widely. There were a few ‘jazz hand’ type greetings from Cuban and other colleagues, choosing not to physically embrace as per normal, although not everyone deemed this necessary. Resisting warm hugs among friends not seen for many years was difficult, as it is in many places in the world just now. But things changed dramatically after the official state news announcement in the middle of the conference of the first case of COVID-19 identified in Trinidad, reportedly among visiting tourists from Italy. When we came down for breakfast the next day, the woman at the reception desk of the conference hotel had what looked like a triple protection of improvised face masks on, none of which could conceal the obvious fear behind her eyes of foreign visitors as she stood far back from the front desk and responded to queries.
During the following days as the cases slowly increased, news filtered along networks and encounters with fellow travellers and Cubans. This included the corralling of a group of tourists in Trinidad confined to a certain portion of a paladar or restaurant in the city after the first cases were identified; a reversal of the normal restrictions that have historically been placed on Cubans in other tourists areas, so evident when I had been visiting Cuba previously. Chance conversations with hotel staff or taxi drivers revealed other themes. Some were optimistic, pointing to the antivirals being developed in Cuba by the State’s biotech industry that could potentially tackle the virus or highlighting how the public health system was prepared for this. Others spoke of how the heat in Cuba was protective and how the increasing temperatures in Spring and Summer would ensure the virus would not take hold. These are far from just rumours, but in fact reflect the ongoing and urgent questions being addressed by scientists inside and outside Cuba in trying to understand and potentially mitigate the effects of the virus. Rumours about COVID-19 abound of course in many places in the world just now and social media here as everywhere is a vehicle that serves to both amplify that space and also crucially inform. But access to the internet in Cuba is not as easy for all, so it is perhaps potentially less a pathway for both the rumour mill that surrounds the virus, but also for the benefits of information exchange than in other places.
Shopping in my local Aldi in London this morning after returning from Cuba and being met by the empty shelves created by panic buying led to further reflections about the ability of Cuba and Cubans to confront the current situation. Empty shelves have been a norm in Cuba for over 20 years, requiring ingenuity and creativity including informal economies of exchange for many of the essentials of life. Cuban friends said there were worrying signs of such times returning with the intensification of the embargo on Cuba from the Trump led administration. ‘No hay carne en el supermercardo’ (there is no meat in the supermarket) said one, echoing a situation of desperate need Cubans had confronted in the late 1980s, following the collapse of the Soviet subsidies. The coronavirus will not help this situation, even without global economies continuing to lock down and close borders. Nevertheless I wonder if in some ways this is more familiar territory for Cubans than for us? Making do, finding a way, being creative with what is available is something that has been a way of life for many there for a long time. A shortage of masks had for instance prompted the government to immediately repurpose textile factories to shift from making school uniforms to face masks. This also became evident in the last few days of our stay in Cuba. As we travelled for a short visit to the nearby city of Cienfuegos, less well resourced places did not have soap (still in fact expensive for many normal Cubans). Yet improvised hand wash in old plastic bottles made with water and diluted alcohol or bleach for everyone to use were made available and were in fact compulsory for everyone entering and leaving public spaces such as bus stations.
As I write I read that Cuba has agreed to allow the stricken British cruise ship with confirmed cases of coronavirus to dock in Havana and facilitate flights home for those on board, prompting the UK to officially thank the Cuban government for this. Such gestures carry both political and moral weight that you might hope would be reciprocated in some way if and when required. As tourists empty out of the cities, beaches and towns of Cuba fearing not necessarily the virus, although that will surely come too, but the possibility of not being able to return to their home country, there is however a definite sense of anxiety among Cubans about what this means for a country that has become so increasingly dependent on tourism and where health care, despite its notable successes, is for many fragile and fractured. I share that fear, yet also wonder if perhaps a long history of enforced resourcefulness and necessarily acquired ability to ‘resolver’ will mean better ways of confronting what is unfolding across the world. I hope that we may yet have much to learn from Cuba in this current moment of crisis.
ABOUT THE AUTHOR:
Sahra Gibbon is an Associate Professor in the Medical Anthropology Department at UCL.
(pictures courtesy of Jennie Gamlin)
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