People's Democracy

Viva Cuba! Viva Socialism!

Brinda Karat

‘CUBA must move ahead with changes, not in unseemly haste, but at the same time, without pause.’ This was a phrase we often heard in the numerous discussions and meetings the CPI(M) delegation had during its visit to Socialist Cuba (see People's Democracy, April 8-14). It is a rough translation of a quotation from. Raul Castro, the president of Cuba and first secretary of the Communist Party of Cuba. It sums up how the Cuban communists view the challenges that face Cuba and their decided course ahead.

Reports in the international media interpret the implementation of the Sixth Party Congress Guidelines of the Economic and Social Policy of the Party and the Revolution (2011) as a shift away from socialism towards a neo-liberal framework. The cuts in social subsidies are cited as proof. The Communist Party of Cuba has refuted these charges as misrepresentation. According to the Communist Party of Cuba, changes are taking place in Cuba designed to make Cuba self-sufficient and self-reliant so as to defend, protect and advance socialism in Cuba.

Friends and supporters of Cuba across the world know well the context in which these changes are taking place.

CONTEXT OF

THE CHANGES

The anti-human blockade of Cuba by the United States, referred to as the Empire by all the Cuban leaders we spoke to, is the iron framework imposed on this valiant people within which the severe problems created by the collapse of the Soviet Union and the Comecon, the group of socialist countries which were the main trading partners for over 30 years after the revolution, have had to be dealt with. To give a few examples, according to the data cited to the CPI(M) delegation in the course of a most lucid presentation by Gladys Hernandes, deputy director of the Institute for Research on the World Economy, Cuba lost 98 per cent of its oil requirement, 85 per cent of its food and cattle feed requirements, 75 per cent of its spare parts and raw materials in the year following the disintegration of Comecon. The relationship with the Comecon was not seen as one of dependence but of complementarity within the socialist world, with Cuba providing these countries with their requirements of sugar, nickel, tobacco, fruits and some raw materials. In the seventies and eighties Cuba had a booming economy, far ahead of all the other Latin American countries, but it also meant a particular framework in the development of the productive forces with emphasis on those sectors felt necessary at that time. Thus there was a severe crisis which engulfed the economy when trade was virtually eliminated.

Cuba was forced to adopt what is referred to as a closed form of development, where options were very limited and resources were scarce. The following decade of suffering and extreme sacrifice was known as the Special Period when the state had to play a direct role at every level of the economy in order to save the interests of the people, ensure employment, wages and social security. Almost the entire population became dependent on the state. This was the period when the road of privatisation of healthcare and education, adopted by so many countries including India, across the world, was firmly rejected by the Cuban leadership. In spite of the crisis, the development of a public health and education system was fully maintained. The sterling achievements of Cuba on this count are consistently underplayed in biased media reports referred to earlier.

Cuba has now entered a new chapter of defending the gains of the socialist system while dealing realistically with the urgent economic challenges. With the victory of progressive forces in many Latin American countries, the isolation of socialist Cuba has been broken. In particular, the close relations with Venezuela and mutual help and support between the two countries, including oil imports from Venezuela, has created an improved environment for Cuba to take forward its next phase of development.

The emphasis now is on the development of the productive forces, of industry and manufacturing, of food self-sufficiency. Five areas have been selected, namely food production, mining (Cuba has large nickel deposits), fishing and processing industries, biotechnology and tourism. The issues of public transport, connectivity and communications are also high on the list of priorities. The current approach to the social sector is in accordance with the socialist principle of each according to his/her capacity to each according to his/her work.

Some of the areas and issues discussed with the delegation are of direct relevance to the popular demands being raised in India and shows the sharp contrast between the neo-liberal policies in India and those of socialist Cuba.

FOOD SECURITY,

FARMERS & CONSUMERS

Unlike India, Cuba is not self-sufficient in the production of foodgrains or food items. About 60 per cent of Cuba's food requirements have to be imported, costing around 1.5 billion dollars, depending on international prices. The government is giving incentives for the people to turn to farming as their main occupation. But it is not an easy task. At present, with a literacy rate of 99 per cent and a large population of graduates, only 20 per cent of the population depend on an income through agriculture or living on the land. Young people whose families were earlier linked to agriculture, have received higher education, a large number of them graduates who prefer to work in urban areas. We were told that non-sugar agricultural production had increased by 18 per cent in the last few years.

Most of the land in Cuba belongs to the state through the nationalisation of the huge farms of landlords who ran away from Cuba after the Revolution. There are also small peasant farmers who have their own land from before the Revolution. There are also those small peasants who received land through the agrarian reform programme. Now as part of the reform process, state land is being is being leased out to individuals and groups at low rates. Workers and employees in the state sector are being encouraged to relocate to agriculture and to form cooperatives. Production of food items like rice, fruits, vegetables and beans is being encouraged. Whereas earlier the farmers were selling only to the state and the state was the sole distributor, now they can have direct contact with buyers --- like hotels, for example, or other enterprises.

The incentives include bank loans at low interest rates between two and seven per cent. The state is also subsidising the inputs like diesel, electricity, seeds and fertilisers. A litre of diesel which would cost 25 pesos in the open market, is available to farmers at the highly subsidised rate of 50 cents. Cattle feed is also subsidised for cattle raising enterprises. The newly introduced tax rates based on gross production are substantially lower for food items.

The CPI(M) delegation had a first hand experience of the different aspects of the new agricultural policies with a visit to the province of Maya Beque which has a population of 3.81 lakhs. In this single province, there were different types of land relations: (1) There were 58 cooperatives being run by groups of farmers with land leased from the state free of cost. The farmers decide what they want to grow and where they want to sell. Five per cent of gross production is paid to the state as tax. The farmers were making a good income, the equivalent of or slightly more than average earning in the state sector. (2) There were 18 cooperatives formed by farmers who owned their land. They farm individually but have formed cooperatives to pool their resources and take joint decisions on production and sale. (3) There are state farms with farm workers mainly producing sugarcane.

In this province, with a population of 23,000 at peasant, agricultural production increased from 2,12,455 tonnes to 2,26,687 tonnes in one year --- between 2011 and 2012. Incomes have also increased. This in turn is attracting younger sections to come back into agriculture. We were also told that the government is closely monitoring the developments and provides a safety net for individual farmers and cooperatives when production is hit by drought or the frequent hurricanes which bring devastation in their wake as happened when three hurricanes hit Cuba in 2010.

Thus the policy is to encourage the development of agricultural markets, to utilise the vast tracts of fallow land, keeping the interests of farmers centre stage in a sustained drive to increase production, productivity and incomes to make Cuba self-sufficient in food.

AS for the fishing sector which too is linked to the issue of food security, as an island state there is tremendous potential to develop the fishing industry. However, there continues to be a huge  problem of spare parts for its shipping fleet. For 20 years Cuba had to rent its ships. Cuba has developed sweet water fish for its domestic use, so that the shortages have been met. Efforts are on now to augment the shipping fleet.

THE PUBLIC

DISTRIBUTION SYSTEM

In India, in spite of huge food stocks, the government has refused to accept the demand for a universal right to food and to scrap the highly unfair targeting system. But Cuba, in spite of the many difficulties and the increasing international prices which make the imports of food items even more difficult, has ensured the provision of rations to its population through a universal public distribution system. Whether in the state or in non-state sector, whether in industry, services or agriculture, every one of Cuba’s 11 million citizens has a minimum entitlement through the rationing system. It is for this reason that, unlike India where malnutrition is growing, the world hunger index 2012 lists Cuba as one of the better performing countries among the top, as far as tackling hunger issues is concerned. The UNICEF report on child malnutrition also mentions Cuba as the best performing country in Latin America and again among the top countries as far as successful efforts towards the elimination of child malnutrition. Earlier, there was a list of about 18 non-food items which were also provided by the state. This list has now been cut.

The food security system is impressive and provides a basic food basket. The list I saw put up in a ration shop on an unplanned visit, included all this and more: rice, black beans, cooking oil, white sugar, brown sugar, fruit juice for children, powdered milk, and fresh milk every day for children, salt, coffee. The rations, which cover about half of the monthly requirement of an individual, also include chicken, eggs, sausages and mince meat. The subsidies for each product are substantial. This provides a cushion for the items which have to be bought from the market.

There are also special provisions for sick people, those with special diet needs like pregnant women, elderly citizens.

In the last two years a debate was initiated by the government to curtail food subsidies and to start the targeting system for specific social sections such as single mothers, old age pensioners, children and so on. There was a widespread debate throughout the country and a strong reaction against doing away with the rationing system. The government revised its guidelines and has decided to continue its subsidies on food.

STATE OF

HEALTHCARE

The implementation of the right to health and education for all it's citizens in Cuba is truly inspirational. The term primary health has a completely different meaning in Cuba which is perhaps unique in the world. Primary health has many tiers and for different sections of the population. The delegation had the opportunity to spend time at a polyclinic and meet with the doctors, nurses and health personnel to understand the system. While the emphasis in most countries is on developing super specialities based institutions, Cuba learning from its earlier experience has given priority in developing the concept of family doctors and a unified and integrated health system starting from the basic unit of a family/ individual in a specified locality, instead of a fragmented one based on super specialisation. This does not mean however that Cuba does not have such institutes. There are 13 super speciality institutes which can compare with the best in the world.

The system starts with the family doctor and his team of a nurse and at least one medical assistant as the basic working group in a neighbourhood; this group is linked to the next tier which is the polyclinic, there are 400 across the country; in addition in every municipality there are also special clinics for medical assistance for pregnant women and also separate clinics for patients requiring special geriatic care. In every district there are also specialised clinics to help people with disability related special needs. 

The third tier is that of the hospitals of which there are 257 and then the fourth tier is of the specialized institutes.

Cuba has a doctor-patient ratio of one doctor for every 150 people and one nurse for every 300. (India has an abysmal ratio of one doctor for every 2000 people.) The reason this has been possible is that medical education is absolutely free in Cuba, from admissions, to books, to tuitions. There are no capitation fees in Cuba, no under the table bribes to get into medical college. We were told anyone who has the required grades and the commitment to serve the people has the opportunity to join the medical colleges. In Cuba the slogan of health for all has real meaning.

In the particular area we visited which was the Plaza municipality, there are 9,833 homes for which there are 25 consulting rooms of doctors throughout the area. Each team looks after 300 families.

In cases where the patient requires further investigation and advanced medical assistance, the family doctor refers the patient to the polyclinic which is considered as a primary health centre. Some 80 to 90 per cent of the medical problems are solved between the family doctor and the polyclinic.

The clinic itself is a study, in contrast with the public health centres (PHCs) in India or even with district hospitals in our country. It has sophisticated equipment for diagnosis including ultrasound machines, endoscopy and caters to a range of medical problems ranging from heart disease, cancer diagnosis, providing physiotherapy for orthopaedic problems, to the more common problems. The clinic also has dentists. Everything, from consultation to tests to treatment is absolutely free. No user fees in Cuba! A poster in the polyclinic reminds people: Health is Free! But in the market it would cost 25.30 pesos for consultation, and 32.50 pesos for an inter consultation.

Our interpreter, David Lopez, told us that last year his family doctor had suggested that he should have his heart functioning checked. The polyclinic in his area referred him to the hospital. Tests found that there were three blockages in the arteries. The hospital put in three stints. Even in a government hospital in India this would have cost at least a lakh of rupees. In Cuba it was free. Every week David goes to a physiotherapy clinic for exercises and once a month for a consultation.

With such a robust health system, the health profile of the Cuban population is among the best in the world. The infant mortality rate in Cuba is 4.2, better incidentally than its powerful neighbour where the IMR is 6.81. In India it is around 52. Life expectancy for women is 79.8 years and for men 77 years.

An enviable record, but the doctors the delegation met were extremely modest about the achievements. They believe that the main challenge is how to further improve the quality of service in a sustained way.

Cuban medical services have helped countries across the world. At any given time you will find Cuban doctors selflessly serving poor populations in African and in other Latin American countries, the unnamed heroes of the Cuba's socialist system and its best ambassadors.

THE STATE

OF EDUCATION

We were unable to visit any of the educational institutions or universities. But we did see well appointed schools, primary and secondary in all the neighbourhoods we visited or passed through. It is compulsory for all children to go to school at least till the higher secondary level. Cuba has a network of committees at the neighbourhood level, called Defence of the Revolution Committees, which interact with families to ensure school attendance. From pre-school level to university and professional education, there are no fees. Each university has hostels for out of town students, also free of charges.

As part of the changes and the thrust towards self-employment, vocational education is being encouraged and a range of new courses to help enhance skills are being introduced. The Young Communist League’s team we met told us that 60 per cent of high school students are training for technical careers.

One of the issues in Cuba is how to gain access to new communication technologies to enhance knowledge. The US blockade prevented access to Internet technology as satellite communications were blocked. Now with the help of Venezuela a fibre optic cable is being laid which has started operating but it will be some time before there is universal access. Around 1.3 million connections to Internet exist at present and the number of cell phones is also growing.

The strength of the political commitment and vision of the  communist leadership in Cuba to ensure the welfare of  the Cuban people, combined with the sustained policies of providing free education and health services to all its citizens, has overcome the huge impact of the blockade as far as social services are concerned and ensured that Cuba is among the top 20 countries in the fulfilment of the UN’s millennium development goals. A record which betters that of the Empire.

(Next Week: Workers and Women in Cuba)