AIDS and Human Rights in Cuba:
I had also just read in the Miami Herald that about 70 journalists and political dissidents had been jailed two weeks earlier in Cuba.
As a U.S. citizen arriving in Cuba, albeit with a "general license" granted by the Treasury Department of the United States, I was nervous.
Even when Castro united with the Soviets and the revolution became socialist, the Cuban revolution continued to be a popular cause for some Americans. The U.S. government, on the other hand, quickly turned against Castro, and its position has not changed in 40 years.
Before visiting, I had no first-hand knowledge of Cuba. I had never expected to go to the island, and it was only because of my work in the area of human rights and treatment access for people with AIDS that I was now landing there.
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 that most gay intellectuals had either left or wound up in jail. However, things had supposedly improved in recent years.
People with AIDS had been quarantined during the early years of the epidemic, but mandatory quarantining had been discontinued in 1993 and they were now receiving "state of the art" anti-retroviral treatment (thanks to local generic production).
"Human rights" focus
Cuba had been selected to host the bi-annual Latin American AIDS Conference, known this year as "Foro 2003," which attracts more that three thousand participants from throughout the region, including activists, people living with HIV/AIDS, scientists and physicians.
The Conference was to have a "human rights" focus. Cuban President Fidel Castro visited it twice, while apparently spending the rest of the week making 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."
If that was not enough, when I asked my taxi driver on Friday night what had happened with the ferry boat that had been hijacked on April 2 in Havana harbor, he replied: "Oh that's over, they caught the hijackers and freed the boat. They shot three of the hijackers." I asked, "During the capture?" "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 the international human rights community did in this case. But being right there, at that moment, surrounded by decent and hardworking Cubans, some with AIDS, some not, it was chilling to think that this event had occurred three miles from where I was, just a few hours earlier, and 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.
But in her article, Cuba Fights AIDS Its Own Way, Anne-christine d'Adesky quotes several participants in an HIV/AIDS support group run by Havana's Monserrat church, who spoke on condition of anonymity of some more questionable aspects of Cuba's AIDS policy.
Through d'Adesky, I made contact at the Conference with two men who attend the church program, and went with them one evening to visit the HIV support group. I found about 60 men and three or four women sharing a communal dinner provided by the church. A huge bowl of pork with rice was set on the table. The men and women were also served 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 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), so if anyone reading this can send me these medications, I will try to forward them to these men.
Carlos is a highly educated professional and I asked him if he was able to access the Internet, where he would find the latest information about AIDS on many levels, political, medical, and social. He 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 through to the Internet?" "No," he said, "the government will not allow us to have it."
During more than five years of activist work, my life has centered around my access to the Internet, and the letters that I exchange with NGO's 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, except for a few during the last several weeks, that were related to planning for the Conference.
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 on this idea because it was too late to send letters to PO boxes. Now I knew why there were no e-mail addresses in the ads from Cuban gays.
Privacy and Consequences
But another one, "Manuel," says that 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 it has any defects, you won't find about it unless you are in Cuba.
A person in Cuba who tries to exercise the right to question a defect or problem, or to send and receive information, or to openly ask for donated medications may face unpleasant 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+, 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 wasn't true, you would never find out about it. The government will 'decide' how much HIV there is. And not necessarily by counting cases."
There are no gay organizations in Cuba, and no gay bars and discos. Although, apparently, gays and lesbians are not harassed, as such, by the government, they are also not allowed to organize formally or open a safe, public meeting place.
Much of the gay life seems to take place in the streets surrounding the huge Havana Libre hotel, where dozens of men appear after 10 p.m. Almost all of the action in this area seems to revolve around sexual tourism.
I wondered how long I, as an AIDS activist, would last in Cuba, if it were one of the target countries of the Treatment Access/Human Rights Program funded by the Association I direct. I also tried to imagine the demonstrations and "zaps" held by activist friends in the United States happening here, 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 at the Conference.
In the afternoon, I bumped into Carlos at the Conference and remembered something else I wanted to ask him about the Internet situation in his country. "Please, not here," he whispered.
Richard Stern is Director of the Agua Buena Human Rights Association in San José, Costa Rica. He works to improve access to treatment for people living with HIV/AIDS in Central America.