Section: Cuba
Published: 18 April, 2003
AIDS
and Human Rights in Cuba: A Personal Memoir
by Richard Stern
As
the plane taking me to the Second Latin American AIDS conference
on HIV/AIDS was getting ready to land in Havana, Cuba on April 6th.
I was reading an article from the Amfar* (AIDS) Treatment Insider
by Anne-christine d'Adesky about AIDS in Cuba, which discussed the
pros and cons of the Cuban government's approach to the AIDS epidemic.
The author had written to me personally just before my departure
and suggested I read the article.
Simultaneously,
I had just read in the Miami Herald that about 70 journalists and
political dissidents had been jailed two weeks earlier in Cuba.
Finally
as a U.S. citizen arriving in Cuba, albeit with a "license"
granted by the Treasury Department of the United States, I was nervous.
Fidel Castro's photo from Time magazine had been posted on the wall
of my bedroom as a 7th grader back in Chicago in 1959. This young
revolutionary who had overthrown the Dictator Batista was a hero
to many young Americans, including those of us living in pampered
circumstances and attending private schools in prosperous suburbs
of the USA, those of us who really knew absolutely nothing about
the reality of poverty, violence, revolutions, and counter-revolutions.
But
subsequently things had changed. The Cuban revolution continued
to be a popular cause for some Americans, even when Castro united
with the Soviets and the revolution became socialist, but our government
quickly turned against Castro, and its position has not changed
in 40 years.
In
my case, I had no first hand knowledge. I had never expected to
visit Cuba, and it was only because of my work in the area of human
rights and treatment access for People with AIDS that I was landing
in Cuba at all. I had only a "layman's" awareness of life
in Cuba. I knew that gays had been harassed in the early years of
the revolution, and most gay intellectuals had either left or wound
up in jail. However, supposedly things had improved in recent years.
People
with AIDS had been quarantined during the early years of the epidemic,
but were now receiving "state of the art" anti-retroviral
treatment, and Cuba had been selected to host the bi-annual Latin
American AIDS conference, known as "Foro 2003," which
attracts more that three thousand activists, People Living with
HIV/AIDS, scientists, physicians, etc. from throughout the region.
(Mandatory quaranting was discontinued in 1993.)
I
now live in Costa Rica and many Costa Rican friends of mine with
liberal leanings had visited Cuba during the 1990s and returned
generally with glowing reports about the people, the health care
system and other aspects of the situation situation there, blaming
the economic boycott by the United States for most of the problems
faced by the country.
Cuban
President Fidel Castro visited the Conference, which was to have
a "human rights" focus, twice, while apparently having
spent the rest of the week being sure that the 70 recently arrested
Cuban dissidents were silenced and jailed. One writer had received
a 25 year sentence for "maintaining contact with foreign journalists."
If
that were not enough, when I asked my taxi driver Friday night what
had happened about the ferry boat that had been hijacked on April
2nd in Havana Harbor, he replied. "Oh that's over, they caught
the hijackers and freed the boat. They shot three of the hijackers."
"During the capture?" I asked.
"No,"
he answered "They captured them Tuesday and held the trial
and the judge found them guilty and they were shot this morning.
I was astounded. I couldn't imagine such an event occurring. When
I asked about the men's lawyer, the taxi driver just smiled.
Its
easy enough to see news of an event such as this on TV, and to "condemn
it" as was to occur in the international human rights community,
but being right there, in the moment surrounded by decent and hardworking
Cuban people, some with AIDS, some with not, it was chilling to
think that this event had occurred three miles from where I was,
just a few hours earlier, and that Cuba's President, who condoned
these executions, supposedly ordered by a Judge, was to appear and
give the closing address at the AIDS conference the following day.
People
with AIDS in Cuba that I met at the Convention seemed satisfied
enough with their country's AIDS program which is heralded throughout
the region as a "model." Cuba has the lowest incidence
of AIDS in the region with just 3,200 reported cases in a country
of 11 million people, and anti-retroviral access is universal.
But
Ms. D'Adesky in her article about AIDS in Cuba commented on a program
at a Church called Monserrat which provides a support program for
People Living with HIV/AIDS and she interviewed several men who
attend that program, who spoke on condition of anonymity of some
aspects of Cuba's AIDS policy that were not so positive.
Through
Ms. D'Adesky, I was able to make contact at the Conference with
two men who attend the Church, and went with them to visit the HIV
support group on the evening of April 10th. I encountered about
60 men and three or four women having a communal dinner which the
Church provided. A huge bowl of pork with rice was on the table
and, as the men and women sat at tables they were served the rice,
a small salad and something to drink. I was invited to share the
meal with them.
With
respect to Cuba's alleged universal access to treatment, two men
I met at the Church were concerned that they had developed resistance
to the first line cocktail they were taking, but the medication
they needed to be taking is not available in Cuba. They were asking
for donations of Agenerase and Abacavir, not available in Cuba (or
most other parts of the developing world) so if anyone reading this,
can send me these medications I will try to forward them to these
men who left me a mailing address.
Carlos,
another church group member, told me that he had felt embarrassed
during the Conference that same day when he spoke to an activist
from Argentina who identified herself as a "sex worker."
"Did you say Social Worker?" he asked her. She explained
to him that the Sex Worker was a commonly used term to reflect the
empowerment of the community of sex workers in Latin America. Carlos
only knew the term "prostitute." He is a highly educated
professional and I asked him if was able to access internet, where
he would find the latest information about AIDS on many levels,
political, medical, and social. He explained to me that Internet
is impossible to access in Cuba unless you own a business or have
a government permission. I was astounded and asked "But if
everyone in this group (meaning the 60 people in the Church) combined
their resources, and bought a computer, you mean you still couldn't
get Internet?" "No, he said, the government will not allow
us to have it." During five years of work in activism, my life
has centered around my access to Internet, and the letters that
I exchange with NGO's and people living with HIV/AIDS from almost
all of the Latin American and Caribbean countries. Only at that
moment did I realize that I had never received a letter from any
Cuban with HIV/AIDS. (except for a few during the last several weeks,
that were related to planning for the Conference)
I
recalled that, thinking of my impending visit to Cuba, a few days
before leaving, I had skimmed the personal ads section of Costa
Rica's gay newspaper, remembering that there are always ads from
gay Cuban men wanting to exchange correspondance. I thought it might
be interesting to meet one of them while I was in Havana. Strangely
enough, none of the 11 ads from Cubans had an e-mail address, only
post office boxes to write to. I gave up this idea because he was
too late to send letters to PO Boxes. But now I knew why there were
no e-mail addresses in the ads from Cuban gays.
In
her article, Ms D'Adesky had referred to Cuba's policy of contact
tracing quoting one of the Church group members, Cheo (not his real
name) as stating that "It's supposed to be a decision of the
person to disclose, to take charge of their situation and inform
the people they've had relationships with," said Cheo. But,
according to "Manuel", gay people who test positive are
asked to name all of their sexual partners during the past five
years. If they refuse they can be taken to the Sanotorium where
they will be held until they cooperate. This practice was not mentioned
by Fidel Castro in his closing speech to the Conference.
The
point was becoming clear to me. Cuba's AIDS program is described
as "excellent" and it may well be "excellent."
But if it isn't, or if there are any defects, you won't find about
it unless you are in Cuba.
The
right to question a defect or problem or to receive additional information,
or send information, or to openly ask for donated medications may
result in consequences. Cubans with AIDS are, apparently, receiving
generally good medical attention, but the concept of AIDS as a disease
that is related to "human rights" does not exist for them.
Cheo
told me that in the AIDS clinics he is well treated and there is
no discrimination. "But in other government institutions, once
they known you are HIV+, they treat you in a degrading manner and
you just have to accept it," he said. "I think Cuba does
have one of lowest rates of AIDS in all of Latin America,"
he added, "but if that wasn't true, you would never find out
about it. The government will "decide" how much HIV there
is. And not necessarily by counting cases."
In
Cuba, there are no gay organizations, and no gay bars and discos,
although apparently gays and lesbians are not harassed, as such,
by the government. But they are also not allowed to organize formally
or open a safe, public meeting place. Much gay life seems to take
place in the streets surrounding the huge "Havana Libre"
hotel, where dozens of men appear after 10 p.m., but almost of the
action in this area seems to revolve around sexual tourism.
I returned
the next day to the Conference with a heightened sensitivity to
the issues facing Cuban People with HIV/AIDS. They had helped to
organize the Conference and in many workshops and plenary sessions
they praised their government's policies toward them. To the man,
and to the woman. There was no criticism, constructive or other.
I wondered
how long, I, as an AIDS activist would last in Cuba, if that were
to have been one of the target countries of our Treatment Access/Human
Rights program for which the Association I direct is funded. I imagined
the demonstrations and "zaps" held by activist friends
of mine in the USA, and could only picture a firing squad.
Glad
that my thoughts could not be read by others, I continued with the
work I had to accomplish in the Conference.
In
the afternoon, I bumped into Carlos and I remembered that I wanted
to ask him something else about the internet situation. "Please,
not here," he whispered.
(*AmfAR
= American Foundation for AIDS Research)