AIDS and Human Rights in Cuba
A Personal Memoir
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 6, 2003, I was reading an article from the American Foundation for AIDS Research's AmFAR 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 and 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.
Encountering Cuba First-Hand
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" antiretroviral treatment, and Cuba had been selected to host the bi-annual Latin American AIDS conference, known as "Foro 2003," which attracts more than three thousand activists, People Living with HIV/AIDS, scientists, physicians, etc. from throughout the region. (Mandatory quarantining 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 healthcare system and other aspects of the situation there, blaming the economic boycott by the United States for most of the problems faced by the country.
Cuban President Fidel Castro twice visited the Conference, which was to have a "human rights" focus, 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."
As 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.
It's 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 not, it was chilling to think that this event had occurred three miles from where I had been just a few hours earlier. It was also chilling 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.
Trouble in Paradise
People with AIDS in Cuba who 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 antiretroviral 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. She interviewed several men who attend that program, who spoke on condition of anonymity, about 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 that 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).
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 "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 he was able to access Internet, where he would find the latest information about AIDS on many levels, political, medical, and social.
Carlos explained to me that the Internet is impossible to access in Cuba unless you own a business or have 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 access to Internet, and the letters that I exchange with non-governmental organizations (NGOs) 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.
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 correspondence. 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 it 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.
Coercive AIDS Policies
In her article, Ms D'Adesky had referred to Cuba's policy of contact tracing. She quoted 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." 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 sanatorium 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 out about it unless you are in Cuba.
The right to question a defect or problem or to receive additional information or to 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 know you are HIV-positive, 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 weren'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 all 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 that 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.
Richard Stern, Ph.D. is the founder and director of the Agua Buena Human Rights Association, based in San Jose, Costa Rica, which conducts advocacy work on human rights and HIV/AIDS issues throughout Latin America.
This article was provided by Body Positive. It is a part of the publication Body Positive.