Cuba: Reporting in Times of Cholera

http://www.havanatimes.org/?p=74222

Cuba: Reporting in Times of Cholera
July 12, 2012
Fernando Ravsberg*

The sale of food in the streets of Cuba rarely meets the necessary
health standards. (Photo: Raquel Perez)

HAVANA TIMES — Very soon we'll have to read the Cuban press using
technical dictionaries to allow us to understand what they're talking
about. Now, for example, they are telling us that something called
Vibrio cholerae has been detected in the city of Manzanillo.

It seems they avoided telling us about cholera to spare us the worry. In
that same sense, we were calmed by the assurance that the three Cubans
who died with this diagnosis were old people who were also suffering
from other diseases.

According to my colleagues at Ediciones Martes, "Fortunately the Cuban
health system has nothing to do with journalism." They claim that the
doctors are better organized, have a plan of action and the system is
run by people who "graduated in medicine."

Undoubtedly the media can look enviously at the professionalism of the
public health care system in Cuba, with its preventive nature, its
long-term strategies, its capacity for rapid response and the respect
that society has for its physicians.

But now the Ministry of Health has new challenges, such as protecting
people from diseases that Cuban aid workers might bring back with them
from abroad, exercising control over the tens of thousands of
self-employed workers who sell food, and monitoring the joint venture
foreign companies operating on the island.

Large companies such as the Havana Water Department (Aguas de La Habana)
must be required to carry out their roles. That company spends part of
its budget on the purification of water in the network while there are
thousands of leaks and pollution sources that lead to the loss of half
of the city's "potable" water.

The presence of Cuban medical teams in Haiti fighting cholera is
laudable, but the truth is that this involves exposing thousands of
doctors to the disease, which means that controls or quarantines should
be in place upon their return to prevent the "pollination" of the disease.

The twofold risk of Vibrio cholerae: From abroad and at home

Cuba has thousands of aid workers serving in Africa in many sectors,
from health care to construction, and any of those individuals might
return with cholera or other harmful microorganisms.

Given the amount of money these professionals produce for the country, a
hotel could even be devoted to them, one which would combine the
necessary quarantines with their well-deserved rest. This would probably
cost less than a health campaign such as the one in Manzanillo.

But the problems are not only coming from abroad. During the
macro-crisis and the mini-opening of the economy in the 1990s, I did a
report on "El Manguito," a town in Matanzas Province in which a private
fried-food vendor killed dozens of people.

The man was carrying around malanga…or corn (I don't remember which) in
a bag contaminated with insecticide. With this he made the dough, fried
it and sold his treats.

He ended up in jail but suffered a much harsher punishment, since one of
the dead was his daughter.

I don't mean to imply that the danger comes only from self-employed
workers, because I know that terrible things happen everywhere. But the
truth is that in the state sector there are certain rules and practices
that reduce health risks.

A food specialist explained to me that while health standards are also
violated in state-run enterprises, the difference is that it's easier to
"trace" the problem to ascertain its origin, place and the moment of
contamination.

With over 400,000 self-employed workers in the streets — most of them
devoted to food service — it is imperative to put effective disease
control mechanisms in place that serve to protect the consumer,
certifying that they can eat and drink without endangering their health.

But it won't be enough to deploy legions of inspectors. The key is to
open wholesale outlets that can compete with the prices on the black
market. When a self-employed worker buys their products in these, they
will have greatly reduced the health dangers presented to the public.

This is just one example of how the internal tug-of-war could impede the
internal development of the master plan of reforms, creating a deformed
model with dangerous black holes, the result of negotiations in which
each law is accompanied by a "but."

The authorities authorize the sale of cars, "but" only used ones; they
distribute land, "but" farmers are prohibited from building homes on
those parcels; and they allow self-employment, "but" fail to provide
wholesale outlets that sell those workers the essential supplies.
—–
(*) An authorized Havana Times translation of the original published by
BBC Mundo.