Conditions: Housing and Health

Housing seemed to us to be a mixed success -- certainly not the dismal failure generally reported in U.S. media. After the revolution, government concentrated on improving life in rural areas, and that was the right thing to do because conditions in the countryside had been terrible.

But cities were let go, and things have gotten shabby. Some good urban housing has deteriorated beyond repair. Still, there are no dreadful shanty towns as in so many poor countries in Latin America and elsewhere. Everyone has some sort of home, though it may be crowded or even unsafe by North American standards.

Especially in eastern Cuba, substandard rural housing remains. Some of it even reminded us of housing that we saw when we lived in Africa. The difference was that elecricity and some kind of usable water were available just about everywhere in Cuba. A couple of electric lights, an old fridge, and a radio or black-and-white TV can make a huge difference in quality of life for the rural poor.

Medical care is a more clear-cut success story. There are clinics like this one virtually everywhere. Each Cuban family is assigned a doctor, rather like the primary care physicians in U.S. managed-care schemes. The statistics are impressive. Cuban life expectancy is about the same as in the U.S., and infant mortality rates are lower than in some U.S. cities.

The trouble is that between the U.S. embargo and the collapse of the Cuban economy, clinics are starved for equipment and supplies. This is the surgery of the clinic you just saw. The entire supply of drugs is sitting right on the table.

The doctor, here with his family, went to medical school in his 30's after a first career as an aircraft mechanic. He eventually became licensed in ob-gyn, internal medicine, and pediatrics. But he earned so little money that he couldn't afford a car, a scooter -- even a bicycle. When we met (on our first trip to Cuba in 1999), he was reaching bedridden patients by walking or hitchhiking.

Before we left in 1999, we gave him two bikes. We had brought them to Cuba with the intention of donating them to someone. They were bikes that a friend in the U.S. was throwing out. We just tuned them up -- and the doctor was deeply grateful for them. It's an astonishing thought: a medical doctor with three specialties being grateful for old bikes that U.S. schoolteachers were sending to the dump!

On our second trip, in 2000, we wanted to do something more significant, so we brought medicine. This is a clinic outside Santiago de Cuba, named for Mario Muñoz, a doctor who died in the attack on the Moncada barracks. In 2001, we brought medicine to a similary clinic in Bahia Honda, Pinar del Rio.