[B] This is what is driving current Cuban policy: No one wants a replay of the devastation known as The Special Period![/B]


CMAJ. 2008 July 29; 179(3): 257.
doi: 10.1503/cmaj.1080068.

PMCID: PMC2474886
Copyright © 2008 Canadian Medical Association or its licensors
Health consequences of Cuba's Special Period

* Other Sections?
o REFERENCES


Manuel Franco and colleagues have analyzed some of the health consequences of Cuba's socioeconomic collapse in 1990–1995, when the country lost the funding from the Soviet Union on which it had relied for the previous 30 years.1,2[B] During this period, Cubans essentially experienced a famine: adults had an average daily protein intake of 15–20 g and lost an average of 5%–25% of their body weight. Franco and colleagues neglected to mention many of the negative physical, mental and social consequences of this so-called Special Period.[/B]

The famine in Cuba during the Special Period was caused by political and economic factors similar to the ones that caused a famine in North Korea in the mid-1990s. Both countries were run by authoritarian regimes that denied ordinary people the food to which they were entitled when the public food distribution collapsed; priority was given to the elite classes and the military.3 In North Korea, 3%–5% of the population died; in Cuba the death rate among the elderly increased by 20% from 1982 to 1993.2,4 Thirty thousand Cubans fled the country, and thousands of these emigrants drowned or were killed by sharks in the Gulf of Mexico.[B] Cuba finally accepted US donations of food, medicines and cash in 1993, and a system of private farmers' markets was set up in 1994 to provide easy access to locally grown food.[/B]

The effect of the economic collapse on Cuba's infant mortality rate was softened by a decrease in the birth rate because of poverty, an exponential increase in the number of transvaginal aspirations to end early-stage pregnancies (which are not recorded as abortions in Cuba), the availability of contraceptives supplied by the United Nations Population Fund, and quasi-exclusive health care for infants and expectant mothers. The 60% increase in the direct maternal mortality rate (a measure of maternal deaths resulting from obstetric complications of the pregnant state) and the 43% increase in the total maternal mortality rate during this period in Cuba reflect the collapse of the health care system for adults.4

In its population statistics, the Cuban government has hidden for the past 49 years the fact that 2 million Cubans have emigrated or have died as a result of political executions, wars fought overseas, unsafe emigration and poor health care for adults (particularly for the elderly).4 It is therefore uncertain whether the all-cause mortality rate (with age adjustment done using questionable data from the 1981 Cuban National Census) and the rates of death from diabetes mellitus and cardiovascular disease cited by Franco and colleagues have in fact declined as much as they claimed in parallel with the population wide weight loss.1,2 Cubans have survived for almost 5 decades on a monthly diet of 6 pounds of refined sugar per person, and there has been a resultant increase in the prevalence of diabetes mellitus.4 The prevalence of other risk factors for cardiovascular disease, such as hypertension, alcoholism and stress, has also increased and the prevalence of smoking has remained constant.

Cuba's population is aging, in part because of the emigration of young people since 1959. The deaths of some older Cubans might have been delayed as a result of weight loss, but the same conditions that led to this weight loss also led to the deaths of many young Cubans at sea as they made a desperate attempt to emigrate. If we are to examine the benefits of weight loss during the Special Period, we must also examine the negative consequences of the conditions in Cuba during this period: the deaths, the illnesses and the psychological suffering.

Individual civil rights, political freedom and a growing, self-sustaining market economy that provides ready access to goods and services have been proven to be the key to reducing living and health inequities. In Cuba, individual civil rights and political freedom are repressed.[B] The economy is strictly controlled by the socialist central government and is currently heavily dependent on huge subsidies from Venezuela and Iran.[/B]

Footnotes
Editor's note: The author's name has been withheld in order to safeguard her or his right to free communication.
Competing interests: None declared.

* Other Sections?
o REFERENCES

REFERENCES
1. Franco M, Ordunez P, Caballero B, et al. Obesity reduction and its possible consequences: What can we learn from Cuba's Special Period? CMAJ 2008;178:1032-4. [PMC free article] [PubMed]
2. Franco M, Ordunez P, Caballero B, et al. Impact of energy intake, physical activity, and population-wide weight loss on cardiovascular disease and diabetes mortality in Cuba, 1980–2005. Am J Epidemiol 2007;166:1374-80. [PubMed]
3. Chen LC, Lam D. A penetrating analysis of famine in North Korea. Lancet 2007;370:1897-8.
4. Cuban Health Statistics Bureau. Annual health statistics reports 1973–2006. Havana City: Ministry of Public Health; 1974–2007. Available: www.sld.cu/servicios/estadisticas/ (accessed 2008 June 12).
Articles from CMAJ : Canadian Medical Association Journal are provided here courtesy of
Canadian Medical Association

[QUOTE=Atabey]
[B] This is what is driving current Cuban policy: No one wants a replay of the devastation known as The Special Period![/B]


CMAJ. 2008 July 29; 179(3): 257.
doi: 10.1503/cmaj.1080068.

PMCID: PMC2474886
Copyright © 2008 Canadian Medical Association or its licensors
Health consequences of Cuba's Special Period

* Other Sections?
o REFERENCES


Manuel Franco and colleagues have analyzed some of the health consequences of Cuba's socioeconomic collapse in 1990–1995, when the country lost the funding from the Soviet Union on which it had relied for the previous 30 years.1,2[B] During this period, Cubans essentially experienced a famine: adults had an average daily protein intake of 15–20 g and lost an average of 5%–25% of their body weight. Franco and colleagues neglected to mention many of the negative physical, mental and social consequences of this so-called Special Period.[/B]

The famine in Cuba during the Special Period was caused by political and economic factors similar to the ones that caused a famine in North Korea in the mid-1990s. Both countries were run by authoritarian regimes that denied ordinary people the food to which they were entitled when the public food distribution collapsed; priority was given to the elite classes and the military.3 In North Korea, 3%–5% of the population died; in Cuba the death rate among the elderly increased by 20% from 1982 to 1993.2,4 Thirty thousand Cubans fled the country, and thousands of these emigrants drowned or were killed by sharks in the Gulf of Mexico.[B] Cuba finally accepted US donations of food, medicines and cash in 1993, and a system of private farmers' markets was set up in 1994 to provide easy access to locally grown food.[/B]

The effect of the economic collapse on Cuba's infant mortality rate was softened by a decrease in the birth rate because of poverty, an exponential increase in the number of transvaginal aspirations to end early-stage pregnancies (which are not recorded as abortions in Cuba), the availability of contraceptives supplied by the United Nations Population Fund, and quasi-exclusive health care for infants and expectant mothers. The 60% increase in the direct maternal mortality rate (a measure of maternal deaths resulting from obstetric complications of the pregnant state) and the 43% increase in the total maternal mortality rate during this period in Cuba reflect the collapse of the health care system for adults.4

In its population statistics, the Cuban government has hidden for the past 49 years the fact that 2 million Cubans have emigrated or have died as a result of political executions, wars fought overseas, unsafe emigration and poor health care for adults (particularly for the elderly).4 It is therefore uncertain whether the all-cause mortality rate (with age adjustment done using questionable data from the 1981 Cuban National Census) and the rates of death from diabetes mellitus and cardiovascular disease cited by Franco and colleagues have in fact declined as much as they claimed in parallel with the population wide weight loss.1,2 Cubans have survived for almost 5 decades on a monthly diet of 6 pounds of refined sugar per person, and there has been a resultant increase in the prevalence of diabetes mellitus.4 The prevalence of other risk factors for cardiovascular disease, such as hypertension, alcoholism and stress, has also increased and the prevalence of smoking has remained constant.

Cuba's population is aging, in part because of the emigration of young people since 1959. The deaths of some older Cubans might have been delayed as a result of weight loss, but the same conditions that led to this weight loss also led to the deaths of many young Cubans at sea as they made a desperate attempt to emigrate. If we are to examine the benefits of weight loss during the Special Period, we must also examine the negative consequences of the conditions in Cuba during this period: the deaths, the illnesses and the psychological suffering.

Individual civil rights, political freedom and a growing, self-sustaining market economy that provides ready access to goods and services have been proven to be the key to reducing living and health inequities. In Cuba, individual civil rights and political freedom are repressed.[B] The economy is strictly controlled by the socialist central government and is currently heavily dependent on huge subsidies from Venezuela and Iran.[/B]

Footnotes
Editor's note: The author's name has been withheld in order to safeguard her or his right to free communication.
Competing interests: None declared.

* Other Sections?
o REFERENCES

REFERENCES
1. Franco M, Ordunez P, Caballero B, et al. Obesity reduction and its possible consequences: What can we learn from Cuba's Special Period? CMAJ 2008;178:1032-4. [PMC free article] [PubMed]
2. Franco M, Ordunez P, Caballero B, et al. Impact of energy intake, physical activity, and population-wide weight loss on cardiovascular disease and diabetes mortality in Cuba, 1980–2005. Am J Epidemiol 2007;166:1374-80. [PubMed]
3. Chen LC, Lam D. A penetrating analysis of famine in North Korea. Lancet 2007;370:1897-8.
4. Cuban Health Statistics Bureau. Annual health statistics reports 1973–2006. Havana City: Ministry of Public Health; 1974–2007. Available: www.sld.cu/servicios/estadisticas/ (accessed 2008 June 12).
Articles from CMAJ : Canadian Medical Association Journal are provided here courtesy of
Canadian Medical Association

[/QUOTE]
Yes, people half starve due to US free market polices throughout the period from 1940.
Indian people starved and died in 1941.
German people after the defeat of US financed Hitler in 46-47-48 half starved and died. Although UK was very short we diverted some of our US suppies to Germany without US knowledege as US policy was to let them starve.
Now in places like Bangladesh people are driven off the land into 1 dollar a day jobs supplying textiles to US and are undrnourished as well.
They turned Phillipines into a pineapple plantation driving people off the land with the help of local cohorts and and at the behest of the likes of DelMonte and set up armed guards round the plantations and becuase people could not feed themselves they were undernourished. Ditto but slightly different story in Haiti.

Yes, Cuba did not have the right agricultural policies....... but greedy capitalistsin US even stopped voluntary organisations in US from sending aid as they did to Germany following the end of WW11

The last sentence is rubbish - in India inequality has grown due to these policies. Where do you find such rubbish!

S.

National Review
July 30 , 2007

The myth of Cuban health care has been debunked in article after article, for the last several decades. (Remember that Castro took power in 1959.) But Michael Moore has given the myth fresh legs, necessitating another round of such articles. If I had a nickel for every article I’ve read entitled “The Myth of Cuban Health Care” . . . But here is another one.

SEPARATE AND UNEQUAL

To be sure, there is excellent health care on Cuba — just not for ordinary Cubans. Dr. Jaime Suchlicki of the University of Miami’s Institute for Cuban and Cuban-American Studies explains that there is not just one system, or even two: There are three. The first is for foreigners who come to Cuba specifically for medical care. This is known as “medical tourism.” The tourists pay in hard currency, which provides oxygen to the regime. And the facilities in which they are treated are First World: clean, well supplied, state-of-the-art.

The foreigners-only facilities do a big business in what you might call vanity treatments: Botox, liposuction, and breast implants. Remember, too, that there are many separate, or segregated, facilities on Cuba. People speak of “tourism apartheid.” For example, there are separate hotels, separate beaches, separate restaurants — separate everything. As you can well imagine, this causes widespread resentment in the general population.

The second health-care system is for Cuban elites — the Party, the military, official artists and writers, and so on. In the Soviet Union, these people were called the “nomenklatura.” And their system, like the one for medical tourists, is top-notch.

Then there is the real Cuban system, the one that ordinary people must use — and it is wretched. Testimony and documentation on the subject are vast. Hospitals and clinics are crumbling. Conditions are so unsanitary, patients may be better off at home, whatever home is. If they do have to go to the hospital, they must bring their own bedsheets, soap, towels, food, light bulbs — even toilet paper. And basic medications are scarce. In Sicko, even sophisticated medications are plentiful and cheap. In the real Cuba, finding an aspirin can be a chore. And an antibiotic will fetch a fortune on the black market.

A nurse spoke to Isabel Vincent of Canada’s National Post. “We have nothing,” said the nurse. “I haven’t seen aspirin in a Cuban store here for more than a year. If you have any pills in your purse, I’ll take them. Even if they have passed their expiry date.”

The equipment that doctors have to work with is either antiquated or nonexistent. Doctors have been known to reuse latex gloves — there is no choice. When they travel to the island, on errands of mercy, American doctors make sure to take as much equipment and as many supplies as they can carry. One told the Associated Press, “The [Cuban] doctors are pretty well trained, but they have nothing to work with. It’s like operating with knives and spoons.”

And doctors are not necessarily privileged citizens in Cuba. A doctor in exile told the Miami Herald that, in 2003, he earned what most doctors did: 575 pesos a month, or about 25 dollars. He had to sell pork out of his home to get by. And the chief of medical services for the whole of the Cuban military had to rent out his car as a taxi on weekends. “Everyone tries to survive,” he explained. (Of course, you can call a Cuban with a car privileged, whatever he does with it.)

So deplorable is the state of health care in Cuba that old-fashioned diseases are back with a vengeance. These include tuberculosis, leprosy, and typhoid fever. And dengue, another fever, is a particular menace. Indeed, an exiled doctor named Dessy Mendoza Rivero — a former political prisoner and a spectacularly brave man — wrote a book called ¡Dengue! La Epidemia Secreta de Fidel Castro.

INFANT MORTALITY

When Castro seized power, almost 50 years ago, Cuba was one of the most advanced countries in Latin America. Its infant-mortality rate was the 13th-lowest in all the world, ahead of even France, Belgium, and West Germany. Statistics in Castro’s Cuba are hard to come by, because honest statistics in any totalitarian society are hard to come by. Some kind of accounting is possible, however: Cuba has slipped in infant mortality, as it has in every other area (except repression). But its infant-mortality rate remains respectable.

You might suspect a story behind this respectability — and you are right. The regime is very keen on keeping infant mortality down, knowing that the world looks to this statistic as an indicator of the general health of a country. Cuban doctors are instructed to pay particular attention to prenatal and infant care. A woman’s pregnancy is closely monitored. (The regime manages to make the necessary equipment available.) And if there is any sign of abnormality, any reason for concern — the pregnancy is “interrupted.” That is the going euphemism for abortion. The abortion rate in Cuba is sky-high, perversely keeping the infant-mortality rate down.

Many doctors, of course, recoil at this state of affairs. And there is much doctor dissidence on the island. Some physicians have opened their own clinics, caring for the poor and desperate according to medical standards, not according to ideology or governmental dictates. The authorities have warned that, in the words of one report, “new dissidences in the public-health sector will not be tolerated.” Anyone trying to work outside of approved channels is labeled a counterrevolutionary or enemy agent.

Furthermore, the shortage of doctors on the island is acute — which is strange, because there are abundant Cuban doctors. Where are they? They’re abroad. In fact, a standard joke is that, in order to see a Cuban doctor, a Cuban must contrive to leave the island.

In his film, Michael Moore speaks of the “generosity” of Castro’s health programs. What he means, in part, is that Castro has long sent doctors overseas on “humanitarian medical missions.” These missions are an important part of the dictator’s self-image, and of his image at large. Cuban doctors go to such “revolutionary” countries as Chávez’s Venezuela, Morales’s Bolivia, and Mugabe’s Zimbabwe. The missions are lucrative for Castro, bringing him about $2.5 billion a year.

Yet they are somewhat risky for him, too. The Cubans abroad are vigilantly watched, and the regime seldom sends unmarried doctors: They want wives and families back home, as hostages. Still, the Cuban doctors defect, and do so by the hundreds. They make a run for it in every country in which they serve, in any way they can. For example, doctors in Venezuela flee into Colombia; others try a friendly embassy, or start yelling in some international airport, during a transfer. Many of the doctors’ stories are heart-stoppingly dramatic. And when they have secured asylum, they tell the truth, about Cuban medicine both at home and abroad.

One of the things that sicken them, about their foreign service, is that they see what Cuba can provide: in equipment, in medications, in personnel. And yet this bounty is not available to Cubans (ordinary Cubans). It is sold to foreigners, to keep Castro’s regime in business.

And this brings up a point concerning Castro’s apologists: If they must concede that Cuban health care is a shambles, their fallback position is that it’s all the fault of the American “embargo.” And yet Cuba has no problem taking care of people in other countries, for show and profit. Moreover, American trade with Cuba in medical goods is virtually unfettered, and American humanitarian aid is considerable.

THE PRESENCE OF HEROES

Above, I spoke of doctor dissidence — and a particularly painful aspect of Moore-like myth-making is that some of the most courageous, most admirable, and most persecuted people on the island are doctors: men and women who have rebelled against health-care injustices and injustices in general. Oscar Elías Biscet is possibly the most noted of such people. He is in one of Castro’s most wretched dungeons. Michael Moore would not even think of taking his cameras to it (and, in any case, he would not be allowed).

Biscet, like so many of the human-rights figures, happens to be “Afro-Cuban.” And, as Mary Anastasia O’Grady of the Wall Street Journal has pointed out, the regime is especially vicious toward such figures, because they are supposed to be grateful for all the Revolution has done for them. Dr. Mendoza, who wrote about dengue, is also Afro-Cuban. So is Dr. Dariel “Darsi” Ferrer.

He has managed to stay out of prison, somewhat miraculously — perhaps because there has been a fair amount of international attention on him. Ferrer operates the Center for Health and Human Rights. In 2005, he penned a statement called “Health Authorities and the Complicity of Silence.” Though he has avoided prison, the regime has subjected him to terrible abuses, including actos de repudio, or acts of repudiation. These are those lovely episodes in which mobs are unleashed on your home, family, and friends.

Hilda Molina Morejón is another doctor-dissident — a stunning case. She was the country’s chief neurosurgeon, the founder of the International Center for Neurological Restoration. She was also a deputy in the National Assembly. In the early 1990s, however, the regime informed her that the neurological center would start concentrating on foreigners, who would bring their hard currency. She objected, resigning her positions and returning the medals that Castro had awarded her. Then came actos de repudio and all the rest of it (but not prison). She has been forbidden to leave the island, and is banned from practicing medicine. She manages, despite the circumstances, to speak out.

“Live not by lies!” said Solzhenitsyn. “Live not by lies!” And yet Cuban Communism and its enablers have lived by them for a half-century. Totalitarians always depend on these lies. Robert Conquest, the great scholar of the Soviet Union, remembers a health official telling him, in private, that many hospitals lacked even running water. Yet public assertions were much different. And there have always been Potemkin-style visits, such as Moore’s. He is simply more talented than most of the others.

Once Communism collapses in Cuba — or if it does — will there be a reckoning? When I was growing up, East Germany was presented to me, by misguided teachers and professors, as a fine social democracy. Earlier this year, a movie called The Lives of Others won an Academy Award. It told some of the truth about East Germany. What will future generations make of Sicko, particularly its portrait of Cuba?

In the meantime, the movie will do a lot of harm, cementing the myth of Cuban health care, among other myths. Castro’s health minister, José Ramón Balaguer, is well pleased. “There’s no doubt that a documentary by someone of Michael Moore’s stature will help the world see the deeply humane principles of Cuban society,” he said. You wonder, sometimes — in the face of constant and powerful myth-making — whether articles in magazines, and the daring and anguished testimonies of Hilda Molina et al., and the cries of an entire society, can make a dent.

I have an indelible memory, from the mid-1980s. Armando Valladares was at Harvard, speaking to students. He had emerged from 22 years in the Cuban gulag, and had written the memoir Against All Hope. (Valladares is often called the Cuban Sol¬zhenitsyn.) In the Q&A, the kids spouted at him the usual line about Cuba: health care, literacy, and blacks. They had been carefully taught it by their teachers. And Valladares answered, in essence, “It’s all untrue — a pack of lies. But even if it were true: Can’t a country have those things without dictatorship, without tyranny, without gulags, without torture — with freedom?”

There is no omelet. There never is. But even if there were — so what?

ABC is in denial, denial, denial, denial, denial, denial, denial, denial, denial, denial, denial,

Many people in Bolivia, Haiti, away from cities in Venezuala and in huge areas of other countries were lucky to see a doctor EVER in their lives.

Good medicine is not only doctors - also preventative medicine - vaccination programs, school food progams etc. etc.
"
The program is the government’s response to an enormous conundrum: what to do about the staggering numbers of villagers like Marrama — an estimated 600,000 people in Andhra Pradesh alone — who go untreated every day, when there is an even more staggering shortage of doctors and nurses.

An estimated 600,000 people in Andhra Pradesh go untreated every dayNumber crunch

The van, equipped with a few basic medical tools and over-the-counter medications, somehow seems a feeble response. But it is a response in a nation where experts say at least 600,000 more doctors and a million nurses are needed to achieve the 1:1000 doctor-patient ratio recommended by the World Health Organization.

It is a tall order for a country that graduates 30,000 new doctors and 45,000 nurses annually. It all but makes equitable access to healthcare impossible.

Currently, there are 60 doctors for every 100,000 people in India, a significant improvement from the 50:100 000 ratio that existed when India achieved independence in 1947.By comparison, India’s Planning Commissions pegged the rate at 209 in Canada and 548 in the US when it noted last year that the "overriding requirement in the country is for increasing the supply of human resources at all levels, from specialists to paramedical personnel, and to improve their quality."

"
http://southasia.oneworld.net/fromthegrassroots/coping-with-indias-rural-doctor-shortage
S.

He is incorrigible

For sure I love the definition of incorrible...........

It is necessary that when the statement is true, it is believed to be true.

The world would be a better place following this - but Gringo and Atabey follow:

It is necessary that when the statement is untrue, it is believed to be true.

S.

14 September 2010 Last updated at 13:20 ET
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Cuba lay-offs reveal evolving communism
seamstress stands outside shop Many Cubans will be urged to form private cooperatives

Cuba is to lay off huge numbers of state employees, in the biggest shift to the private sector since the revolution in 1959. But this is not the end of communism in the country, writes Stephen Wilkinson of the Centre for Caribbean and Latin American Research and Consultancy.

The media frenzy that has followed the announcement that Cuba is to reduce its state workforce by 500,000 by the middle of 2011, is similar to that which followed Fidel Castro's throwaway remark last week that the Cuban model isn't working - it has largely missed the point.

This is not the end of socialism in Cuba.

Working it out
Cuban taxi

* Workers at the ministries of sugar, public health, tourism and agriculture will go first
* Many workers will be urged to form private cooperatives
* Ideas for cooperatives include raising animals and growing vegetables, construction jobs, driving a taxi and repairing automobiles

Source: Associated Press

The announcement yesterday by the Cuban Workers Confederation is highly significant and it does spell the final death knell of the old Soviet model of centrally planned socialism in Cuba, but it would be very wrong to interpret it, as some have, as the harbinger of free market capitalism and liberal democracy.

Far from it. The changes are couched in the rhetoric of revolution and the discourse is very much one of deepening the socialist character of the system rather than one of shifting towards capitalism.

Unlike the prospect of suddenly being left without work that faces many in the UK, as the present government's budget cuts loom, these cuts in Cuba are being undertaken after a long period of consultation with the trade unions and other organisations.

Workers know what is going to happen to them. The programme is to be undertaken in stages, the effect on people's livelihoods is to be mitigated and it is important to understand that the announcement does not mean that all the 500,000 workers mentioned are to become unemployed.

A large number of them will be offered alternative employment opportunities and a good many will continue in their jobs but will cease to be employed by the state anymore.
Continue reading the main story
“

This is a far cry from the egalitarian days when workers were expected to labour for no recompense other than their own moral good and of the country and fellow Cubans”



In many cases it means that they will become self-employed or become part of a workers' cooperative.

Taxi drivers for example, or shop workers and workers in small manufacturing enterprises, all of whom are currently state employees, will essentially take over the administration of their own workplaces and earn their salaries directly from their takings or revenues rather than being a salaried state employee.

They will essentially be doing what they have always done - but they will no longer be on the state's payroll.

In cases where workers are made redundant they will be encouraged to set up new business or transfer to other sectors.

This does of course imply a huge change towards a system in which the market dictates the distribution of goods and services and this in turn also implies other significant changes.

As one Cuban economist put it to me recently, the role of the state is to be transformed from being the administrator of economic activity to the regulator.

Cuba GDP graphic


The state is therefore withdrawing a good deal of its paternalistic character. Workers will not be guaranteed employment or the indefinite payment of their salary while out of work any more - they will be expected to look for and find work for themselves.

Workers will have to provide their own lunches instead of having a subsidised canteen and they will have to find their own way to work instead of being picked up by the company bus.

However, at the same time, the incentive to work will be enlarged through bonuses and pay based upon productivity. There is no longer an upper limit on what one may earn.

Workers will be encouraged therefore to move into unpopular jobs such as construction and agriculture by the possibility of earning more in those sectors.

Other sectors that the government says it is going to expand in the coming months are in oil, tourism, biotech and pharmaceuticals where it says there will be new job opportunities.
Continue reading the main story

All of this is a far cry from the egalitarian days when workers were expected to labour for no recompense other than their own moral good and that of the country and fellow Cubans.

The statement on Monday therefore also implies a significant shift in the ideological underpinning of the system.

There is by implication a shift towards greater individualism and self reliance and the acceptance that there will be differential incomes and therefore different living standards among the population.

Welfare is to be directed by means testing to where it is needed rather being applied universally regardless of individual income.

All this sounds very familiar to people in Britain, who have witnessed debates on these matters recently, but how this will play out in the longer term in Cuba will be interesting to see.

Another interesting area to watch will be how the changes may increase the pressure in the US for the administration there to change its policy towards the island.

As the market increases in Cuba and more people become self-employed and low level enterprises are freed to run themselves, those who are arguing for the US to engage with island in order leverage this process and move it further down the free market route will have a stronger basis for their case.

This news, following the recent release of political prisoners, makes change on the other side of the Florida Straits more likely than ever.


* April 2010: Cuba begins turning over hundreds of state-run barber shops and beauty salons to employees
* August 2010: President Raul Castro says the role of the state is to be reduced in some areas, with more workers allowed to be self-employed or to set up small businesses
* September 2010: Cuba announces radical plans to lay off huge numbers of state employees to help revive the economy

However, it would be wrong in the short term to see the reforms as leading inevitably to a change in the political organisation inside Cuba.

Cuba is to remain a one-party communist state for the foreseeable future.

This leads some to suggest that the Cubans are following a Chinese or Vietnamese model. True, there are similarities between the two Asian tigers and what was announced yesterday.

The Cubans have certainly studied both models closely. But my sources tell me that at a very high level, while the economic progress of the pair impressed, neither met with approval in their entirety.

Cuba, they say, wishes to avoid the negative social consequences of the Chinese experience.

A more laudable direction of travel is towards Latin America where Cuba recently announced that it was seeking to eventually form an economic union with Venezuela.

Hugo Chavez is leading Venezuela away from the free-market capitalist model towards what he calls "21st Century Socialism". Interestingly this includes encouraging workers' co-operative enterprises. Might this be Cuba's first step towards meeting Chavez half way?

As with all things Cuban, we can only wait and see, but this is certainly a carefully planned change that has been four years in the making - since Raul Castro took over in 2006 - and will certainly not be as traumatic as commentators in the media have suggested.

Stephen Wilkinson is at the Centre for Caribbean and Latin American Research and Consultancy, London Metropolitan University

Cuba would not have survived so long if they did not get some things right!

S.