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AIDS quarantine in Cuba:

Care & prevention, not repression

Lavender & red, part 99

Published May 26, 2007 7:49 AM

From both a scientific and human standpoint, the AIDS sanatoria health care facilities in Cuba bore no relation to the threat of state quarantine in the U.S.

In the U.S., there was no scientific merit to public proposals to empower the state for surveillance and quarantine of people believed to have AIDS. There was no way to identify how many people out of the vast population had already been exposed. The epidemic was already entrenched. AIDS was not spread through casual contact. And anti-gay and racist scapegoating, laws against same-sex love, immigrant bashing, and laws against IV drug use and prostitution had generated fear of the state, as well as of coming forward for testing or treatment.

So threats of state investigation and forced isolation only drove the epidemic deeper underground. The prohibitive costs of medical care, particularly for those without health insurance, also barred many from seeking health care.

Yet on March 2, 1984, USA Today revealed that California officials were legally pursuing the ability to forcibly quarantine people believed to have AIDS. The same month, the Democratic co-chair of the Connecticut General Assembly’s Judiciary Committee introduced broad quarantine legislation after a racist media campaign demonized a Black woman, accused of prostitution and drug addiction, who was reported to have AIDS.

Even as politicians were refusing to allocate the funds necessary to meet this public health emergency, the big-business media were unjustly accusing Haitian immigrants in the U.S. of spreading AIDS.

The late Michael Callen told Workers World at that time that the press for quarantine powers was “not really to protect people but to further certain political goals, to further isolate already disenfranchised people.” Callen said that the singling out of a Black woman in Connecticut and allegations without scientific basis that Haiti and Africa were the sources of the epidemic were attempts “to blame all calamity on the Third World.” (Workers World, April 5, 1984)

Gay men and bisexuals were blamed for the epidemic for much the same reason that the church hierarchy in the Middle Ages accused Jewish people of creating bubonic plague by “poisoning the wells.”

Media in the South and Jerry Falwell’s right-wing fundamentalist publication “Moral Majority Inc.” editorialized that AIDS was God’s “deserved punishments” against homosexuals. (aidssurvivalproject.org)

Far-right columnist Patrick Buchanan titled his commentary: “AIDS Disease: It’s Nature Striking Back.” (New York Post, May 24, 1983)

That’s why the late Bobby Campbell, a San Francisco registered nurse with AIDS, told Workers World on March 25, 1984, how concerned he was about the political abuses of broad quarantine measures in the U.S. He warned, “We would see gay men locked up en masse and it is possible in more backward localities that lesbians could be included in that.”

The U.S. government declared war on people with AIDS rather than marshal funds and forces to deal with the epidemic.

Science, not scapegoating

By contrast, Cuba—an island nation of 11 million that was blockaded by U.S. imperialism—had prepared its health care system for the epidemic two years before its first diagnosis of an AIDS case. So when AIDS first emerged in the population, it could be easily identified and isolated before being spread to the rest of the people.

In 1986, Cuba opened up 13 sanatoria that provided care for 99 people, only 20 percent of whom were believed to have contracted AIDS through same-sex contact. (Denver Post, Feb. 10, 2003)

Joseph Mutti wrote from Havana in June 1999, “Once a person has tested HIV-positive, attempts are made to trace everyone who had sexual contact with the person. Given Cubans’ general openness about their sexuality, and Cuba’s cradle-to-grave health care system, it’s usually possible to ascertain how and when a person was infected.

“The basic principle of the Cuban public health-care system, widely recognized as the Third World’s best,” Mutti explained, “is to prioritize the health of the population as a whole instead of focusing exclusively on individual care. This is important for understanding HIV/AIDS policies, including the sanatorium system that earned Cuba an unfair reputation for employing repression to counter the virus.” (“Love and Honesty: The Dawn of Gay Rights,” Resource Center of the Americas.org)

The newspaper Granma explained Cuba’s reasons for using quarantine: “The main usefulness of this measure is to slow down as much as possible the epidemic progression of the disease to allow time for other measures of disease control to have a medium- or long-term effect, such as education (encouraging changes in sexual habits and behavior), until such time as a vaccine and treatment exist, auguring a definitive solution to the problem.” (“Cuban Strategy in the Struggle Against AIDS,” Granma, Sept. 18, 1988)

When asked about the Cuban approach to AIDS, then-Cuban Deputy Public Health Minister Hector Terry explained in October 1987, “The quarantine center is a sanatorium. We have a very small number of people carrying the virus, and we believe that because of that, we are in a unique situation. We have an opportunity, in epidemiological terms, of controlling the spread of AIDS and preventing it from becoming a major epidemic as it has in other countries, where they don’t know how to confront, reduce or eliminate it.

“We are in a situation that permits us to make this kind of decision, and to wait a while because we are not talking about something permanent, for a whole lifetime. We’re talking about a dialectical situation.”

Terry added, “This aspect [quarantine] is controversial, some groups of scientists disagree with it.” He said that the objections were “more from a political than a scientific standpoint. But we believe our country has this epidemiological opportunity and we shouldn’t lose it. We are trying to prevent the spread of the virus throughout the country by means of sexual relations that our patients could have with other people who at this point have not been infected with the virus.”

“Our country has its own philosophy and the first principle of this philosophy is respect for human dignity. I think that human dignity requires care of the individual. You know that we spare no resources here to make sure that our people have the best health care possible anywhere in the world. And that’s part of what we’re trying to maintain in our battle against AIDS.” (Interview with Karen Wald, Guardian, Oct. 28, 1987)

The best care—for free

Cuba provided free health care to its population despite economic obstruction by the U.S. and later the devastating loss of its main trading partner, the Soviet Union. Cuba organized its scarce resources—not just to stem transmission of the epidemic, but to provide humane care.

“Organized like small communities,” MEDICC Review wrote, “the sanatoriums are made up of apartment complexes and small houses, plus infirmary, offices and other patient facilities.” (Vol. II, No. 1, 2; 2001)

People with AIDS received healthy food, medications and other treatment, air-conditioned housing, exercise and sports, movies, television, videos, rest, and psychological and social services; everything was free except cigarettes.

Cubans with AIDS continued to receive their full paychecks, even if they weren’t able to work. Their jobs were held open indefinitely. Terry stressed, “This is very important, so that they have no concern regarding the support of their families.

“What other country in the world would be capable of paying full salary to people with AIDS? Terry asked. “I think that’s very linked to the whole question of human rights and the controversies around this. We know there are countries that shout about human rights, such as the U.S. where a person who gets AIDS may die of hunger, lose his job, it’s hard to get into a hospital. Treatment there costs an average of $700 a day.”

Terry added that the Cubans’ families also received special attention. A working group of psychologists, sociologists and social workers helped the families of people with AIDS deal with their problems, as well. Terry concluded that people with AIDS had greater peace of mind knowing their families were being cared for.

Next: Cuba declared war on AIDS, not on people with AIDS

To read more about Cuba, read parts 86-98 of Lavender & Red at workers.org.

E-mail: lfeinberg@workers.org