Posted by rogerhollander in Criminal Justice, Cuba, Foreign Policy, Labor.
Tags: adriana perez, alan gross, bob menendez, Criminal Justice, Cuba, cuban five, fidel castro, foreign policy, john kerry, Latin America, oakland ross, raul castro, roger hollander
Roger’s note: here is just another example of Obama following the same foreign policy as bush and his predecessors with respect to Latin America, as with his ((and Secretary of State Clinton’s) tacit support for the coup in Honduras and Paraguay, not to mention Venezuela. As a Latin Americanist I am more than disgusted with Obama and his phony campaign gimmick about change you can believe in.
JOSE GOITIA / Toronto Star file photo
The Cuban Five, who were convicted in Miami of espionage, are portrayed on a billboard near Havana as then Cuban president Fidel Castro delivers a speech, in this photo from June 23, 2001
She’s 43 years old, childless, and lives in Cuba, while her husband of a quarter-century is incarcerated in a U.S. maximum-security prison, having served just 14 years of a soul-crushing sentence — two life terms plus 15 years.
So what are the odds that Adriana Perez and her spouse, Gerardo Hernandez, will ever have a child together?
Right now, those chances are looking extremely slim.
Or, as Perez put it just the other day: “It’s another one of our rights that is being violated.”
In this case, the right to bear children.
An intense, somewhat diminutive woman with dark, striking features and a crown of wavy black hair, the Cuban activist was in town last week to address an assembly of about 160 mostly left-leaning Torontonians. They crowded into the United Steelworkers Hall at 25 Cecil St. to hear a tale of American hard-heartedness and duplicity, at least as it’s framed by one of its victims.
In the United States, however, the same individuals are vilified as foreign spies, criminals who broke the law and who richly deserve to be behind bars.
Behold the core configuration of Cuba-U.S. relations in the early years of the third millennium: a tale of five Cuban convicts — plus one yanqui detainee.
The gringo in this story is a 63-year-old American by the name of Alan Gross, who is currently doing time in a Cuban jail.
Put them together, and what you’ve got is possibly the main obstacle to progress on what may well be the most bizarrely dysfunctional bilateral relationship in the world, a state of bitter enmity that has alternately fumed and flared for more than 50 years, pitting Washington and Havana in what some regard as the final battleground of the Cold War.
The Cold War, of course, is over — and ideological disagreement no longer has much to do with the stubborn antipathy that continues to dominate U.S.-Cuba relations.
Even the experts seem stymied by the remarkable and seemingly illogical persistence of the dispute.
“There is no explanation,” says Larry Birns, director of the Council on Hemispheric Affairs, a Washington-based think-tank. “This is the war without end — the war against Cuba.”
To some degree, that war can now be reduced to a conflict over prisoners — five Cubans and one American.
Where the Cubans are concerned, time is fast running out.
“The real fear is that the United States is essentially destroying the prospects of these families to have children,” says Birns. “The inability to have children confronts all of them.”
It is certainly staring Adriana Perez straight in the face, as she travels the world trying to drum up support for her husband and his four comrades.
In fact, her hopes for children may already be moot.
Dispatched to south Florida in the 1990s, the five Cuban men were on a long-term clandestine mission — no one denies that — but they were not spies in the conventional sense, according to their defenders. They were not interested in undermining the U.S. government or its institutions. Instead, they spent their time monitoring the activities of radical Cuban-American groups fiercely opposed to the government of Fidel Castro and not averse to violence.
Later, Havana offered to share its intelligence with the U.S. government.
Instead of saying gracias, compañeros, American authorities responded by arresting the five Cubans and charging them with a raft of espionage-related crimes.
Lawyers for the five sought to move the trial out of Miami, with its volatile anti-Castro community, but those efforts were rebuffed.
“That was quite shocking,” says Birns. “In south Florida, it’s hard to imagine you could get an impartial jury.”
Impartial or not, the Miami jurors subsequently convicted the defendants on all counts, and the men were sentenced in 2001 to sometimes astoundingly long prison terms, most notably the sentence meted out to the husband of Adriana Perez.
With one exception — Rene Gonzalez, who was released from a federal prison in 2011 but is still serving three years of parole — the Cubans have remained behind bars ever since.
“In spite of this, they have not lost their optimism that they will return to Cuba,” said Perez, who hasn’t seen her husband since the 1990s — and not for lack of trying.
On at least 10 occasions, she has sought a U.S. visa in order to visit Hernández in jail, only to be turned down each time.
This past week, she called on a highly sympathetic Toronto audience to step up their efforts to win the release of the five.
“I ask each one of you, when you leave here, to think, ‘What would I do if it was my son or brother or father who was in jail?’ ” she said. U.S. President Barack Obama “is not going to give freedom to the five spontaneously or because he is a good person.”
What’s needed, she said, is political pressure.
That pressure could take many different forms, but it seems unlikely they will include a prisoner exchange, although the Cubans have earnestly sought one.
Cue Alan Gross, a possibly somewhat naive American who was arrested in Havana in 2009, while working on a “pro-democracy” project funded by the United States Agency for International Development, a contract that involved providing electronic communications equipment to the island’s minuscule Jewish community.
For that activity, the Cubans arrested the American and put him on trial. He is now serving a 15-year sentence for crimes against the Cuban state.
Havana has left no doubt that it would agree to a swap — Gross’s freedom in return for the release of some or all of the five. But Washington says no.
“The U.S. position is these are not comparable detainees,” says Christopher Sabatini, policy director at the Council of the Americas, a research and analysis forum based in New York. “I don’t think the United States is going to budge on this.”
As a result, the two neighbours remain suspended in the same state of mutual hostility and diplomatic paralysis that has prevailed for almost as long as Cuba has been governed by someone named Castro.
Nowadays, the man in charge in Havana is Raul Castro, Fidel’s slightly younger brother and a considerably more pragmatic individual than his elder sibling ever was.
By most accounts, Raul badly wants to ease tensions with Washington — for economic reasons, above all, given the dilapidated state of the island’s economy. But his government also seems deeply committed to securing the release of the Cuban Five.
“They have tried every conceivable measure to show they are conciliatory,” says Birns in Washington. “They are giving away the store in terms of the concessions they are granting. You would think that Washington would want to dance around the maypole.”
Instead, the Obama administration continues to include Cuba on its list of “terrorist” states — a tired anachronism at best — and to maintain its long-running economic embargo against the island.
“We’re in a complete stalemate,” says Sabatini.
It sometimes seems that nothing short of the Second Coming could inspire a change in the official U.S. stance on Cuba.
Consider the recent appointment of John Kerry as U.S. secretary of state. Many observers expected the former Democratic presidential candidate to provide a fresh new look to Washington’s outmoded policy toward the island. After all, he has long advocated a range of measures that would reduce tensions between the two sides. So far, however, there is little sign that Kerry is sparing much time pondering the fate either of the Cuban Five or of the remaining 11 million islanders still sweltering in the Antillean sea breeze roughly 100 kilometres across the Straits of Florida from Key West.
“That’s the shamefulness of it,” says Birns. “This is the great curse. It’s an unvisited policy.”
According to Sabatini, Cuba receives little attention from the State Department in Washington at least partly because the U.S. has far bigger foreign-policy concerns, from North Korea to China to the Middle East.
Besides, he says, improved relations with the island would spell only minor economic and political benefits for the United States, while risking a much more formidable downside — the outrage of Cuban-Americans in south Florida.
“The amount of noise they would cause is huge,” he says. “So why do it?”
In the absence of a clear directive from the White House, he believes it is inevitable that Cuba policy will remain mired in bureaucratic inertia and outdated thinking.
After all, the U.S. Senate’s foreign affairs committee is chaired by Bob Menendez, a retrograde Cuban-American who would not look fondly on ambassadorial candidates with a history of progressive-minded ideas about his ancestral island home.
“The problem is that, for career people in Washington, being behind a Cuba change is a death sentence,” says Sabatini. “They want to be ambassadors. They’d never be approved.”
Still, there may be at least a glimmer of change on the short-term horizon, as Obama prepares to travel to the region next month, a trip that will include stops in Mexico and Costa Rica.
The United States is now the only country in the Americas that does not have normal diplomatic relations with Havana, and Latin American leaders are impatient with what they see as U.S. foot-dragging.
That frustration might be enough to produce a shift in Washington’s tone, if not something more concrete.
“There are rumblings of change,” says Sabatini. “But it will have to come from the White House.”
Meanwhile, Adriana Perez continues to traverse the globe, on an increasingly urgent campaign to secure the release of her husband.
“We hope it comes soon,” she said in Toronto last Saturday, “because it’s already too late.”
For more about Cuba — the good, the not-so-good, and the downright glorious — check out Oakland Ross’s eRead, Cuba Libre. Simply go to stardispatches.com and subscribe for $1/week. Cuba Libre is also available for single-copy purchase at itunes.ca or starstore.ca for $2.99.
Posted by rogerhollander in Cuba, Health, Latin America.
Tags: castro, climate change, Cuba, cuba cdr, cuba health, cuba medicine, dengue, don fitz, health care, heath, katrina, Latin America, medical students, public health, roger hollander
Roger’s note: I am not an uncritical admirer of Castros’ Cuba. However, I have made a fairly extensive study of the Cuban revolution, and in the 1980s and 1990s I traveled several times to Cuba, and by car and plane got to know a great deal of the Island. In general, I found that for the most part the Cubans I met were educated, cultured, “civilized” and with a pride and dignity I have not seen in other Latin American countries. I have met with veterans of the Bay of Pigs invasion and was given a private tour of the museum at that “sacred” place, where a huge billboard advertises it as the “first defeat of imperialism in the Americas.” How much of Cuba’s Stalinist Communist rule is a necessity with respect to the US blockade and belligerence and how much a result of failed socialist imagination, is hard to say. My most memorable experience was when a Canadian with whom we were traveling on our return trip to Toronto had a paranoid attack when we stopped in Camaguay to pick up passengers. He exited the plane and ran out onto the tarmac. My belief is that if this had happened the US he would have been shot dead (and questions asked later). In Cuba, the authorities patiently followed him as he ran about the airfield, amongst both civilian and military aircraft. When he finally tired out, he was detained with minimal force and taken to a psychiatric facility. This is what I mean when I use the word “civilized.”
by Don Fitz, www.blackagendareport.com, Feb. 14, 2012
Fidel Castro long ago vowed to make Cuba a “medical superpower.” The country’s healthcare system emphasizes preventive medicine and mobilization of the entire population against threats to health and safety. Medicine is more than a career. Imagine that, at the height of the Katrina disaster, the US closed medical schools in Gulf coast states and coordinated their work of attending to medical and public health needs of the poorest in New Orleans.”
“Imagine that medical schools across the US sent their students to survey living conditions of poor black, brown, red, yellow and white Americans to determine what causes elevated mortality rates.”
“I’m on pesquizaje,” my daughter Rebecca told me. “All of the third, fourth and fifth year medical students at Allende have our classes suspended. We are going door-to-door looking for symptoms of dengue fever and checking for standing water.” 
As a fourth year medical student at Cuba’s ELAM (Escuela Latinoamericana de Medicina, Latin American School of Medicine in Havana), she is assigned to Salvadore Allende Hospital in Havana. It handles most of the city’s dengue cases. Though she has done health canvassing before, this is the first time she has had classes cancelled to do it. It is very unusual for an outbreak of dengue, a mosquito-borne illness, to occur this late in the season. She remembers most outbreaks happening in the Fall, being over before December, and certainly not going into January–February.
Groups of medical students are assigned to a block with about 135 homes, most having 2–7 residents. They try to check on every home daily, but don’t see many working families until the weekend. The first dengue sign they look for is fever. The medical students also check for joint pain, muscle pain, abdominal pain, headache behind the eye sockets, purple splotches and bleeding from the gums. What is unique about Cuban medical school is the way ELAM students are trained to make in-home evaluations that include potentially damaging life styles — such as having uncovered standing water where mosquitoes can breed.
Dengue is more common in Cuban cities of Havana, Santiago and Guantánamo than in rural areas. Irregular supply of water to the cities means that residents store it in cisterns. Cisterns with broken or absent lids and puddles from leaky ones are prime breeding sites for the Aedes aegypti mosquito, the primary vector (carrier) of dengue. 
DF and DHF
There is a significant difference between dengue fever (DF) and dengue hemorrhagic fever (DHF). DF is a virus which usually lasts a week or more and is uncomfortable but not deadly.  DF has four varieties (serotypes). If someone who has had one type of dengue contracts a different serotype of the disease, the person is at risk for DHF. Early DHF symptoms are similar to DF but the person can become irritable, restless and sweaty, and go into a shock-like state and die. 
DF can be so mild that many people never know that they had it and that they are at risk for the far more serious DHF. This is why the Cuban public health model of reaching out to people is important in preventing a deadly epidemic. There are no known vaccines or cures for DF or DHF — the only treatment is treating the symptoms. With DHF, this includes dealing with dehydration and often blood transfusions in intensive care. [3, 4]
“DF is a virus which usually lasts a week or more and is uncomfortable but not deadly.”
Each year, there are over 100 million cases of DF, largely in sub-Saharan Africa, the Caribbean, Latin America, Southwest Asia, and parts of Indonesia and Australia.  Between 250,000 and 500,000 cases of DHF occur annually and 24,000 result in death. 
Dengue was not identified in Cuba until 1943. Epidemics hit the island in 1977–1978 (553,132 cases), 1981 (334,203 cases of DF with 10,312 cases of DHF), 1997 (17,114 DF cases with 205 DHF cases), and 2001–2002 in Havana (almost 12,000 DF cases). 
Climate, mosquitoes and health
Climate change could make conditions more comfortable for mosquitoes that are vectors for dengue. During the last half a century, Cuban health officials have calculated a 30-fold increase of Aedes aegypti mosquito.  Since the 1950s, the average temperature in Cuba has increased between 0.4 and 0.6°C. Health officials are well aware that “…increasing variability may have a greater impact on health than gradual changes in mean temperature…” 
The 1990s were a very hard time for Cuba. Known as the “special period,” this was when collapse of the Soviet Union caused oil to dry up, the nation’s production (including food) to plummet, and illnesses to increase.  It was also a time when there was a climb “in extreme weather events, such as droughts, and…stronger hurricane seasons.”  Increases in climate variability meant winters have become warmer and rainier.
Conner Gorry, Senior Editor of MEDICC Review in Havana, reports that “My friends and neighbors tell me they can’t remember ever having to fumigate or think about dengue in the winter.”  Another consequence of more ups and downs in the climate is “…insults to the upper respiratory tract, increasing viral transmission, particularly among infants and children.” 
Medical students in Havana come from 100 countries about the globe.  No matter what accent they have when speaking Spanish, they don’t have trouble getting into homes. In Havana, there is nothing unusual about a foreigner in a bata (white medical jacket) walking through homes, poking into yards and peering on roofs to see if there is standing water.
Always in need of extra cash, an enormous number of Cubans have some sort of less than totally legal activity going on in their homes (such as a nail parlor in the living room). But it does not occur to either the resident or the medical student that the inspection would be for anything other than public health reasons.
Cuba has experienced more than half a century of mobilization campaigns like current efforts to control dengue. Soon after the 1959 revolution Cuba mobilized the literacy campaign which sent teachers and students to every corner of the island to teach citizens to read and write. Every hurricane season, the neighborhood Committees for Defense of the Revolution (CDRs) are prepared to move the elderly, sick and mentally ill to higher ground if an evacuation is necessary. Campaigns against diseases like polio and dengue have made Cubans used to the government bringing public health efforts into their homes. 
“Every hurricane season, the neighborhood Committees for Defense of the Revolution (CDRs) are prepared to move the elderly, sick and mentally ill to higher ground if an evacuation is necessary.”
Beginning in the 1960’s, the CDRs worked with thousands of trainers, who, in turn trained 50,000 more Cubans to teach the importance of polio vaccinations. As a result, Cuba has not had a polio death since 1974. CDRs actively encourage pregnant women to regularly visit their neighborhood doctor’s office and patrol the community to enforce the ban on growing succulents that attract mosquitoes. 
Cuba places a very high value on researching preventive medicine. MEDICC Review (Medical Education Cooperation with Cuba) is a peer reviewed open access journal which works to enhance cooperation among “global health communities aimed at better health outcomes.” 
Cuban researchers have played a key role in developing the widely accepted model that DHF is determined by “the interaction between the host, the virus and the vector in an epidemiological and ecosystem setting”  In Cuba, this translates to (a) the most important risk factor for getting DHF is having a second infection of DF which is a different strain; (b) being infected a second time in a specific order of DF strains places children at a higher risk for DHF than adults; (c) white Cubans are at a higher risk for DHF than Afro-Cubans; but, (d) those who already have sickle cell anemia, bronchial asthma or diabetes are at higher risk.
Cuban researchers openly discuss weaknesses in their health care system. One study indicated that there could be a “marked undercounting” of dengue due to missing a large number of cases. This finding occurred even though the study examined data during a time of “maximum alert,” suggesting that undercounting could be very widespread. 
A typical finding is that the community must feel that the dengue control program belongs to them if it is to be successful and sustainable.  Some of the best work I’ve seen on the role of public health takes an honest look at effects of “the absence of active involvement of the community” in dengue control. The authors felt that Cuba’s outdoor spraying of adult mosquitoes “is of questionable efficacy.” Instead, they focused on “the bad conditions or absence of covers on water storage containers” in the city of Guantánamo. 
“Those who already have sickle cell anemia, bronchial asthma or diabetes are at higher risk.”
The study had a control group of 16 neighborhoods which carried out the usual practices of home inspections, measuring the degree of mosquito infestation, and larviciding (applying chemicals to kill mosquitoes during the larval stage of growth). In contrast, their intervention group did everything that the control group did, but added intense involvement by local activists. “Formal and informal leaders” of the community worked with health professionals “to mobilize the population and change behavior,” such as covering water containers correctly, repairing broken water pipelines, and not removing larvicide.
Measuring the number of mosquitoes in the two groups revealed dramatic results. The authors concluded that “Community based environmental management integrated in a routine dengue prevention and control program can reduce level of Aedes infestation by 50–75%.” 
Rebecca told me that when medical students inspect the homes of Havana residents, they find that the overwhelming majority comply with pubic health policy. But some do not. A few cannot afford the proper lid for cisterns. Some have mental problems that limit their ability to cooperate. And a very few just don’t give a damn, even if they could be raising mosquitoes that infect their neighbors. Cuban-style public health research is critical in identifying barriers that communities need to overcome if they are to protect themselves from disease.
Do you remember Katrina and the number of New Orleans residents who languished while the state and national governments did nothing meaningful? Do you remember the photos of 1000 Cuban doctors in batas ready and waiting to come to New Orleans just like they went to Nicaragua, Honduras, Haiti, Venezuela, Sri Lanka, Pakistan and dozens of other countries hit by disasters? Do you remember the government that would increase the suffering of its own people rather than accept help from Cuba?
It may be difficult, but imagine that, at the height of the Katrina disaster, the US closed medical schools in Gulf coast states and coordinated the work of attending to medical and public health needs of the poorest in New Orleans. It may contradict your lifetime of experiences, but imagine that medical schools across the US sent their students to survey living conditions of poor black, brown, red, yellow and white Americans to determine what causes elevated mortality rates and then announced that no one would return to medical school until they were part of a national plan to resolve health care needs.
It may bend your mind to the border of hallucination, but imagine that health care professionals throughout the world demanded that people of the Global South be spared the mosquito infestations, rising waters, droughts, floods, species extinctions and all other manifestations of climate change brought on by the gluttonous overproduction of the 1% in the Global North. Imagine new medical care based on help going to those who need help the most rather than obscene wealth going to those who invest in the sickness industry.
Imagine citizens welcoming health professionals to walk through their homes because they do not fear being reported to the police and because they have seen mobilization after mobilization improve their lives rather than ensnare them in empty promises. Imagine a new society.
Don Fitz (firstname.lastname@example.org) is editor of Synthesis/Regeneration: A Magazine of Green Social Thought. He is Co-Coordinator of the Green Party of St. Louis and produces Green Time in conjunction with KNLC-TV. He can be contacted at email@example.com.
1. My Spanish-English dictionary does not include “pesquizaje;” but Conner Gorry, Senior Editor of MEDICC Review says that Cuban health professionals use “pesquizaje active” to mean “active screening” when they go door-to-door. Email message from Conner Gorry January 24, 2012.
2. Lázaro, P., Pérez, Antonio, Rivero, A., León, N., Díaz, M. & Pérez, Alina (Spring, 2008). Assessment of human health vulnerability to climate variability and change in Cuba. MEDICC Review, 10 (2), 1–9.
3. Dengue fever, A.D.A.M. Medical Encyclopedia. PubMed Health. Retrieved on February 6, 2012 from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002350/
4. Dengue hemorrhagic fever, A.D.A.M. Medical Encyclopedia. PubMed Health. Retrieved on February 6, 2012 from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002349/
5. Vanlerberghe, V., Toledo, M.E., Rodriguez, M., Gómez, D., Baly, A., Benitez, J.R., & Van der Stuyft, P. (Winter 2010). Community involvement in dengue vector control: Cluster randomized trial. MEDICC Review, 12 (1), 41–47.
6. Whiteford, L.M., & Branch, L.G. (2008). Primary Health Care in Cuba: The Other Revolution. Lanham: Rowman & Littlefield Publishers, Inc.
7. Fitz, D. (March 2011). The Latin American School of Medicine today: ELAM,” Monthly Review, 62 (10) 50–62.
8. Medical Education Cooperation with Cuba. Retrieved February 6, 2012 from http://www.medicc.org/ns/index.php?s=3&p=3.
9. Guzmán, M.G. & Kouri, G. (2008). Dengue haemorrhagic fever integral hypothesis: Confirming observations, 1987–2007. Transactions of the Royal Society of Tropical Medicine and Hygiene. 102, 522–523.
10. Peláez, O., Sánchez, L, Más, P., Pérez, S., Kouri, G. & Guzmán, M. (April 2011). Prevalence of febrile syndromes in dengue surveillance, Havana City, 2007. MEDICC Review, 13 (2),47–51.
11. Díaz, C., Torres, Y., de la Cruz, A., Álvarez, A., Piquero, M., Valero, A. & Fuentes, O. (2009). Estrategía intersectoral y participativa con enfoque de ecosalud para la prevención de la transmisión de dengue en el nivel local. Cadernos Saúde Pública, 25 (Supl. 1), S59S70. http://dx.doi.org/10.1590/S0102-311×2009001300006