Cuba brought science, not scapegoating, to AIDS care

Cuba tried to isolate the spread of AIDS as soon as the epidemic appeared in the island population, explained then Cuban Deputy Public Health Minister Héctor Terry in 1987. But Cuba did not try to socially isolate people with AIDS.

Terry stressed of Cubans living in the sanatoria: “They visit their families at home, go out on pass; their families visit them, every day. Their friends can visit them.” (Interview with Karen Wald, Guardian, Oct. 28, 1987)

Cuba attempted to quarantine the spread of the epidemic based on a scientific approach to a medical emergency, without using scapegoating to isolate people with AIDS.

In the U.S., AIDS activists had to fight a protracted battle to replace the bigoted label of “high-risk groups” with a rational understanding of “high-risk behaviors.” Cuban medical workers and educators approached transmission scientifically.

Researchers Lourdes Arguelles and B. Ruby Rich observed in the autumn of 1987 that, “Cuba is unusual in publicizing the disease, not as a gay disease, but rather as a sexually transmitted disease regardless of specific sexual practice.”

The primary route of AIDS transmission in Cuba was via international contact, including Cubans who had worked or studied abroad.

Of the first 99 people quarantined in 1986, only about 20 percent were believed to have contracted AIDS through same-sex contact.

Terry articulated this clearly: “We are carrying out our program by giving the public a lot of scientific information, speaking to them clearly about the modes of transmission and not generating phenomena such as homophobia or sexual repression.

“In some countries the mass media, for commercial reasons, generate those phenomena to sell more magazines or newspapers. But we don’t need to sell more magazines or newspapers. We don’t need to use AIDS to get people to watch more TV or to get some corporation to finance AIDS research. We don’t need any of that here.”

Terry summed up, “We start from the ideas that AIDS is transmitted not because of what you are but because of what you do, and therefore there’s no reason to generate any kind of persecution or phobia against any patient.”

Interviewer Karen Wald added: “Members of the gay community interviewed here said there has been no increase in homophobia or attacks on gays as a result of AIDS. They attribute this in part to the fact that the government has not singled out gays as carriers of the disease.”

And unlike in the U.S., same-sex love was not against the law in Cuba.

Cleo Manago was part of a delegation of 200 people from the U.S. who challenged Washington’s travel ban to visit Cuba in August 1994. Manago wrote about his visit to an AIDS sanatorium in an article entitled “Cuba, from a Black, Male, Same-Gender-Loving Perspective.”

“The widely reported rumors and articles on AIDS concentration camps in Cuba are out of context and pure anti-Cuba propaganda,” Manago stated. “I visited Cuba’s largest AIDS sanatorium and was taken aback by the humane, considerate, intuitive and life affirming approach to care taken by this center.

“The sanatorium was similar to a large housing complex where all who chose to live there had 24-hour health care, the option of having family members, even a dog or a cat stay with them. Same-gender-loving and heterosexual couples living together at the complex is a common occurrence.

“I asked people living there about the conditions in which they live. None were happy about having HIV or AIDS but all were very appreciative of the care they received. Many who could go home if they wanted chose to stay where they were guaranteed prepared food, a comfortable home and prompt medical attention. This particular center offered ambulatory care for those with jobs or who wanted to continue with school. To my knowledge there is nothing similar in the USA.”

Manago concluded, “The main problem people with AIDS faced was the difficulty in getting the medicines and treatments (pentamidine, bactrim, condoms, etc.) needed from other countries, due to the U.S. blockade of Cuba.” (www.sonomacountyfreepress.com)

Dr. Héctor Terry emphasized: “We are treating the patients medically to maintain their present state of good health. Every time some new information comes up in the scientific community, some new kind of drug or medicine, we try to find out if it could be useful in preventing the virus from becoming activated into a full-blown disease.”

Terry added: “Information is reaching the public without any sensationalism, without creating any hysteria or panic. We haven’t yet been using the mass media as much as we should; we think that’s a deficiency in the program. We’ve been using state agencies and all the ministries a lot, organizing conferences for all the workers in certain ministries, especially those in the high-risk areas. We also utilize the health education program and the popular video centers throughout the country. We run videos and have doctors there to answer questions. We’ve used that a lot and many young people attend these.

“We’re now preparing other activities with the mass organizations, the Committees to Defend the Revolution, student and women’s organizations,” he continued. “We are working with other scientific institutions in the country, which are providing invaluable assistance and we are looking at all possibilities anywhere in the world. We try to synthesize what is being done internationally.

“Here we have the SUMA group, which is developing Cuban technology to do mass-scale diagnostic testing. With an infinitesimal blood sample we can diagnose for AIDS. We’ll be trying to get this equipment into all the country’s blood banks next year, and in all the hygiene and epidemiology centers. And we’ll be preparing ourselves for carrying out at least annual blood tests of the whole population, in every blood bank and epidemiology center, in every hospital. We’re preparing a very wide-range program.”

Terry concluded: “I repeat that the method of quarantine in a sanatorium isn’t permanent. It will be treated dialectically. We are studying the situation and when we see that it is not the correct solution, or that other possibilities offer themselves, we will act accordingly—always basing ourselves on scientific data. Otherwise we wouldn’t be scientists.”

Clearly quarantine in Cuba was a tactic at the moment the epidemic emerged, not a scientific principle.

Joseph Mutti wrote from Havana in June 1999: “The government undertook extensive efforts to learn more about transmission of the virus and to discover a cure. It wasn’t until the early 1990s that officials felt enough was known to end the quarantine and focus on public information, education and prevention.” (“Love and Honesty: The Dawn of Gay Rights,” Resource Center of the Americas.org)

Cuba began an out-patient pilot reintegration project in 1993 that proved successful. (Denver Post)

Those who left the sanatoria received ambulatory care that included regular doctor’s care, visits to specialists and dietary supplements—all free. (medicc.org)

However, the Denver Post concluded in February 2003, “Today, 48 percent of those who are HIV-positive or have AIDS choose to live in the 16 sanatoriums around Cuba.”

Next: “Cuba has much to teach

the world about AIDS.”

To find out more about Cuba,

read parts 86-99 of Lavender & Red

at workers.org.

E-mail: [email protected]